Patient's question:
What is ABO hemolytic disease, what are the symptoms of the condition, how should it be treated, and will there be any sequelae?Doctor's answer:
Hemolytic diseases caused by blood type incompatibility between mother and fetus are a blood type-related condition that occurs during the fetal period and early neonatal stage, serving as a significant cause of neonatal hemolytic diseases. Fetal red blood cells carry antigens from the father, resulting in the fetal blood type differing from that of the mother. When fetal red blood cells enter the mother's bloodstream, they induce the mother's immune system to produce antibodies. These antibodies circulate through the bloodstream and cross the placenta to enter the fetal bloodstream, where they bind to fetal red blood cells, leading to their destruction and causing hemolysis in the fetus and newborn. In 99% of cases, neonatal hemolysis caused by ABO incompatibility occurs when the mother is type O and the newborn is type A or B, as the antibodies produced have a small molecular weight and can cross the placenta. ABO blood type incompatibility often leads to hemolysis in the firstborn child, as O-type blood pregnant women have the opportunity to be exposed to ABO blood type antigens before pregnancy: ① intestinal parasites containing blood type antigens; ② certain immune vaccines containing ABO blood type antigens; ③ ABO blood type antigens present in nature in plants and animals. Incompatibility in the firstborn can produce antibodies, leading to hemolysis in the fetus and newborn. However, clinical symptoms are relatively mild. Although the incidence of ABO hemolysis is high, only 10% of neonatal hemolytic diseases are caused by ABO incompatibility. ABO hemolysis is characterized by mild to moderate anemia and jaundice, with rare cases of kernicterus and edema. Laboratory tests: First, blood type identification should be performed, followed by ABO blood type antibody and titer determination. Measuring IgG antibodies in the mother's serum and the titer of anti-A (B) IgG antibodies can predict the occurrence of ABO hemolysis.