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ABO Incompatibility in Newborns: Overview

ABO incompatibility occurs when a pregnant woman has a blood type that produces antibodies against her fetus's blood type. This can cause the infant's red blood cells to be destroyed after birth when maternal and fetal blood mix. The infant is generally not anemic at birth but may develop jaundice, hypoglycemia, and anemia over the next two weeks as antibodies continue to destroy red blood cells. Treatment involves phototherapy, early feeding to remove bilirubin from the blood, and potentially exchange transfusions for severe cases to remove sensitized red blood cells. With treatment, most infants recover without complications.

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227 views14 pages

ABO Incompatibility in Newborns: Overview

ABO incompatibility occurs when a pregnant woman has a blood type that produces antibodies against her fetus's blood type. This can cause the infant's red blood cells to be destroyed after birth when maternal and fetal blood mix. The infant is generally not anemic at birth but may develop jaundice, hypoglycemia, and anemia over the next two weeks as antibodies continue to destroy red blood cells. Treatment involves phototherapy, early feeding to remove bilirubin from the blood, and potentially exchange transfusions for severe cases to remove sensitized red blood cells. With treatment, most infants recover without complications.

Uploaded by

sagameteiro
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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  • Introduction to ABO Incompatibility
  • Pathophysiology
  • Assessment
  • Management

ABO

INCOMPATIBILITY
By:
Marvi Mae Jimena
Rosean Marvi Joy M. Yunsay
ABO blood group
ABO
Incompatibility
 ABO incompatibility is  common and generally mild type of

hemolytic disease in babies


 In most cases of ABO incompatibility, the maternal blood type

is O and the fetal blood type is A.


 It may also occur when the fetus has type B or AB blood.

 The reticulocyte count (immature of newly formed red blood

cells) is usually elevated as an infant attempts to replace


destroyed cells.
Pathophysiology
Etiology:
Unkown

Predisposing and precipitating factors :


Miscarriage
Trauma
Birth(especially during placental separation)
Pathophysiology
Mixing of maternal and fetal blood

Antibodies against foreign blood type is formed

Antibodies circulate through the fetal circulation

Hemolysis of the baby’s blood cells


AN INFANT OF AN ABO INCOMPATIBILITY IS NOT
BORN ANEMIC AS IS THE Rh SENSITISED CHILD.
 

• ABO antibodies are of large (IgM) class and do not cross the

placenta.
• Hemolysis of blood begins AT BIRTH, when the blood and
WHY?
antibodies are exchanged during the mixing of maternal and
fetal as the placenta is loosened
• destruction of red blood cells may continue for up to 2 weeks

of age.
PRETERM INFANTS DO NOT SEEM TO BE
AFFECTED.

This may be because the receptor sites for anti-A or anti-B


antibodies do not appear onWHY?
red cells until late in fetal life.
Even in the mature newborn, the direct Coomb’s test may
be only weakly positive because of the few anti-A or anti-B
sites present.
Assessment
Progressive jaundice within the first 24 hours of life.
Jaundice occurs because as red blood cells are
destroyed, indirect bilirubin (fat-soluble and cannot be
excreted from the body) is released.

Brain damage and Kernicterus can occur


Assessment
Progressive hypoglycemia. An infant needs to use
glucose stores to maintain metabolism in the
presence of anemia.
Decrese in Hgb
Tachypnea
Dyspnea
Tachycardia
Management
Exchange Transfusion
 The procedure involves alternatively withdrawing
small amounts (2-10 ml) of infant’s blood and then
replacing it with equal amounts of donor blood via
umbilical vein catheter
 Procedure lasts 2-3 hours
 removes approximately 85% of sensitized red cells in
ABO incompatibility.
Management
Initiation of early feeding

Bilirubin is removed from the body by being


incorporated into feces. Therefore, the
sooner the bowel elimination begins, the
sooner bilirubin removal begins.
Management
Phototherapy

 Exposure to light triggers the liver to assume


its function which is to process bilirubin.

 Additional light supplied by phototherapy


speed the conversion potential of the liver.
 

POINTS TO REMEMBER during PHOTOTHERAPY


 

 Infant’s eyes must be covered under bilirubin lights

because the retina can be damaged.


 Infants should also wear a gonadal shield

 Stools are often bright green because of excessive

bilirubin. They are also loose and frequently irritating


to the skin.
 Urobilinogen formation may cause dark-colored

urine.
 Monitor temperature.

 Explain importance to parents.

 Turn the infant every two hours to expose different

parts of the infants body


 Monitor I&O.

By: Marvi Mae Jimena Rosean Marvi Joy M. Yunsay ABO INCOMPATIBILITY
ABO blood group
ABO Incompatibility ABO incompatibility is  common and generally mild type of hemolytic disease in babies In most cases
Pathophysiology Etiology: Unkown Predisposing and precipitating factors : Miscarriage Trauma Birth(especially during place
Mixing of maternal and fetal blood Antibodies against foreign blood type is formed Antibodies circulate through the fetal cir
• ABO antibodies are of large (IgM) class and do not cross the placenta. • Hemolysis of blood begins AT BIRTH, when the blo
This may be because the receptor sites for anti-A or anti-B antibodies do not appear on red cells until late in fetal life.
Progressive jaundice within the first 24 hours of life. Jaundice occurs because as red blood cells are destroyed, indirect
Progressive hypoglycemia. An infant needs to use glucose stores to maintain metabolism in the presence of anemia. Decres
Exchange Transfusion  The procedure involves alternatively withdrawing small amounts (2-10 ml) of infant’s blood and then

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