Bonilla ZR, Sánchez HR, Rivera LR, Ambriz FR

Language: Spanish
References: 6
Page: 10-13
PDF size: 50.67 Kb.

ABSTRACT

Hemolytic disease caused by anti-c and anti-E is generally less severe than that caused by anti-D. History, a 26-years-old mother, blood group O Rh(D) positive, Gesta 3, Caesarea 2, previous twin pregnancy. No history of transfusion. It has not been submitted hemolytic disease in the previous two newborns. A 6-days-old female infant, blood group O Rh(D) positive, she presented hyperbilirubinemia since the second day of life (23.7 mg/dL of indirect bilirubin and total bilirubin of 24.1 mg/dL), hemoglobin 15 g/dL, hematocrit of 45%, platelets 345,000, positive direct Coombs. She was treated with phototherapy but also she required blood for exchange; however, transfusion service report said that there are no data of hemolysis. Control of bilirubin at 24 hours was 28.3 mg/dL, at 23 hours was of 23.1 mg/dL and hematocrit of 39%. The exchange transfusion was not realized, because it was not found blood compatible in their hospital. The case was sent to the Central Blood Bank of the National Medical Center Century XXI. Material and methods: Medical history data, blood counts, bilirubin. Blood samples from the mother, father and newborn (1 mL of EDTA). Protocol for Group and Rh(D), Coombs direct and research of specific antibodies in serum and attached to erythrocytes, titration of eluate and phenotypes. Objective: To determine whether Hemolytic Disease of the Newborn (HDN) from parents with Rh(D) positive was caused by alo-antibodies different to anti-D. Conclusions: It was determined presence of anti-c and anti-E antibodies in mother´s serum and also stucked in erythrocytes of the newborn. Often the exchange transfusion and presence of hyperbilirubinemia in newborns is related with mothers Rh(D) negative; however, in this study was seen the importance of control and search of antibodies in the mother during the prenatal period independent of the Rh(D).

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