Erythroblastosis

Its about hemolytic reactions ...

1. Erythroblastosis Erythroblasts …. Immature RBCs. Erythrocytes…….Mature RBCs Erythroblastosis …. Breakdown of immature RBCs

2. Erythroblasts and Erythrocytes

3. Autoimmunization An immune response to foreign antigens after exposure to genetically different cells or tissues. Undesirable outcome of a blood transfusion. Autoantibodies Alloantibodies

4. Autoantibodies React with self-molecules occur in healthy individuals and are referred to as natural antibodies or autoantibodies . Alloantibodies Produced by an individual with allo -antigen which is foreign antigen from other individual of same species.

5. Allo -antibodies Which may occur as a result of from Wrong transfusion Transplantation Mixing of blood during pregnancy

6. Hemolytic Reactions Acute transfusion reaction… Caused by ABO antibodies.Rapid Destruction of RBCs. Delayed transfusion reaction ….occurs after 24 hours of blood transfusion. Hemolytic Disease of newborn …. In which mothers’s alloantibodies reacts against feotus antigens and destroy their immature RBCs known as erythroblasts

7. Rh blood group system Named after the Rhesus monkey, which is the animal where it was first identified. depends on the presence or absence of the Rh antigen.Rh factor can be either present (+) or absent (-) and is referred to as Rh positive if a person have the Rh factor or Rh negative if Rh factor is not present.

8. Importance Rh blood group doesn’t contain any antibody against the Rh antigen,unless the body is stimulated by exposure to Rh antigen. Rh negative person contains neither Rh antigen on its cells nor Rh antibody in its plasma.

9. Erythroblastosis Fetalis Hemolytic anemia and it occurs during transplacental transmission of maternal antibodies to fetal RBCs. The disorder usually results from incompatibility between maternal and fetal blood groups.

10. Rh Incompatibilty Rh (-) woman + Rh (+) man = Rh (+) children Rh positive feotus cross the placental barrier and enter into Rh negative mother’s blood stream. mother’s immue system reacts feotal Rh antigen stimulus by producing a large number of anti- Rh antibodies. mother’s antibodies + feotus RBCs= hemolysis

11. Symptoms Anemia Mother’s antibodies destroy baby's RBCs and the baby develops anemia. The baby's body tries to compensate for the anemia by releasing immature RBCs called erythroblasts from the bone marrow. Liver and spleen to become enlarged potentially causing liver damage or a ruptured spleen.

12. Jaundice Infants have high levels of bilirubin in their blood ,which leads to jaundice. ( hyperbillirubinemia ) Shorter life span of RBCs Unconjugated billirubin binds to albumin travels to liver. Increase reabsorption of conjugated billirubin from GI tract.

13. Kernicterus Free bilirubin is lipid soluble. Deposited in brain. It causes a condition known as Kernicterus .

14. Diagnosis Routine blood Test Feotus Blood Test Indirect Coombs Test Direct Coombs Test

15. Direct Coombs test or DAT RBCs wash to remove plasma RBCs are incubated with anti- hemoglobulin . Antihemoglobulin binds to patient’s antibodies that are attached with RBCs Agglutation indicates positive DAT.

16. Indirect coombs test or IDT The IDT deals with extracted plasma. Unbound antibodies remains in blood Plasma is then incubated with reagent RBCs. Antibodies binds to reagent RBCs. Positivr IDT indicates presence of antibodies in blood.

17. Treatment Rho-GAM Gamma Globulin Outside source of antibodies Administrated 28 th week of pregnancy After 72 hours of Delivery .

18. Vaccination Rho- gam works almost like vaccination Vaccination is dosage of a virus that is too small to cause serious illness. Enables body to fight against virus or any foreign paticle .

19. RhoGam vaccination Contains antibodies to RH (+) But not harmfull enough Mother’s body react to these antibodies and never reacts to fetal antibodies.

20. Amniocentesis Amniotic fluid test which is performed to test fetal infections and also for sex determination. Rho-GAM is also given after amniocentesis.

21. Intrauterine blood transfusion Given to replace fetal RBCs that are being destroyed by mother’s alloantibodies . Keep the fetus healthy until he or she is mature enough to be delivered. Umbilical vein or artery… Umbilical cord vessel Permits absorption of blood .

22. Procedure position of placenta through ultrasound image. Antiseptic solution to clean mother’s abdomen Anesthetic injection to make abdominal region insensitive Needle is inserted

23. Intrauterine-blood transfusion   mother's abdomen into the fetus's abdomen or an umbilical cord vein. A compatible blood type is delivered into the fetus's umbilical cord vessel.