新生儿疾病-Neonatal Jaundice lwz英文最终篇.ppt

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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