Patient's question:
Thank you for Dr. Nai Renshu's detailed reply!According to your detailed explanation, my nephew's condition is classified as neonatal Rh hemolytic disease. Now, the most pressing issue we are concerned about is, what are the common sequelae after treatment? Is there any effective treatment available?
Thank you once again to all the experts for your replies, which have been of great help to us!
Doctor's answer:
Hello:Treatment of newborns
① Induced abortion: Approximately half of stillbirths occur between weeks 34 and 35 of pregnancy. Delivering the baby before the due date through induced abortion can reduce the incidence of stillbirths and neonatal mortality. Based on the results of amniotic fluid testing, considering the patient's history of previous pregnancies, and the titer of maternal serum anti-Rh antibodies, a decision is made on whether to induce abortion. The abortion procedure can be performed 2 to 4 weeks before the due date, depending on the situation.
② Blood exchange transfusion: For patients with relatively late and mild anemia, fresh blood transfusion is usually sufficient.
For cases with severe anemia and jaundice, blood exchange transfusion using serologically compatible blood is the most important treatment. Blood exchange not only replaces the fetal red blood cells covered with antibodies with normal red blood cells, correcting anemia, but also directly removes excessive bilirubin and anti-Rh antibodies from the plasma. If the serum bilirubin level is >5 mg/dL at birth, it often indicates the need for blood exchange transfusion. If bilirubin levels rise rapidly or reach 18–20 mg/dL after blood exchange transfusion, it suggests the need for a repeat transfusion. Exchanging two full blood volumes can remove about 85%–90% of the original fetal red blood cells, but only 25%–30% of bilirubin in the blood and tissues. Adding 5–6 grams of albumin per unit (500 mL) of transfused blood can increase bilirubin clearance.
Although the infant is Rh-positive, the red blood cells transfused should be Rh-negative to avoid the destruction of transfused red blood cells by residual anti-Rh antibodies, preventing new hemolysis and worsening jaundice. Since the patient has