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ID:56374791
大小:141.00 KB
页数:24页
时间:2020-06-14
《新生儿疾病-Neonatal Jaundice lwz英文最终篇.ppt》由会员上传分享,免费在线阅读,更多相关内容在PPT专区-天天文库。
1、HemolyticDiseaseoftheNewbornLiweizhongIntroductionHemolyticdiseaseofthenewbornItisanisoimmunityhemolysisassociatedwithABOorRhincompatibility.ItresultsfromtransplacentalpassageofmaternalantiboddyactiveagainstRBCantigensoftheinfant,leadingtoanincreasedrateofRBCdest
2、ruction.Itisanimportantcauseofanemiaandjaundiceinnewborninfant.EtiologyandPathogenesisABOhemolyticdiseaseABOincompatibilityTypeOmothersTypeAorBfetusesPresenceofIgGanti-AorAnti-BantibodiesintypeOmotherFrequentlyoccurringduringthefirstpregnancywithoutpriorsensitiza
3、tionEtiologyandPathogenesisRhhemolyticdiseaseRhbloodgroupantigens(C,c,D,d,E,e)D>E>C>c>ePathophysiologyofalloimmunehemolysisresultingfromRhincompatibilityAnRh-negativemotherAnRh-positivefetusLeakageoffetalRBCintomaternalcirculationMaternalsensitizationtoDantigenon
4、fetalRBCEtiologyandPathogenesisProductionandtransplacentalpassageofmaternalanti-DantibodiesintofetalcirculationAttachmentofmaternalantibodiestoRh-positivefetalRBCDestructionofantibody-coatedfetalRBCEtiologyandPathogenesisRhhemolyticdiseasewasrareduringthefirstpre
5、gnancyinvolvinganRh-positivefetus.Oncesensitizationhasoccurred,re-exposuretoRhDRBCinsubsequentpregnanciesleadstoananamnesticresponse,withanincreaseinthematernalanti-RhDantibodytiter.Thelikelihoodofaninfantbeingaffectedincreasedsignificantlywitheachsubsequentpregn
6、ancy.EtiologyandPathogenesisSignificanthemolysisoccurringinthefirstpregnancyindicatespriormaternalexposuretoRh-positiveRBC.FetalbleedingassociatedwithapreviousspontaneousortherapeuticabortionEctopicpregnancyAvarietyofdifferentprenatalproceduresTransfusionofsomeot
7、herbloodproductcontainingRhDRBCinanRh-negativemotherClinicalManifestationsJaundiceAnemiaHydropsMassiveenlargementoftheliverandspleenBilirubinencephalopathy(Kernicterus)ClinicalManifestationsClinicalFeaturesOfHemolyticDiseaseLaboratoryDiagnosisLaboratoryFeaturesOf
8、HemolyticDiseaseDiagnosisThedefinitivediagnosisrequiresdemonstrationofbloodgroupincompatibilityandofcorrespondingantibodyboundtotheinfant’sRBC.DiagnosisAntenat
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