How to prevent neonatal hemolytic disease?

The arrival of every baby is something worth celebrating for the family. But some babies are born with diseases, which makes their parents very worried. Hemolytic disease of the newborn is an infant disease caused primarily by incompatibility of the blood types of the current and the infant. So how can we prevent it?

Preventive Care

1. Fetal period

The diagnosis can be made during the fetal period.

(1) Premature delivery: If an Rh-negative pregnant woman has a history of stillbirth or miscarriage, her blood can be taken for immunological examination. If the antibody is positive, the pregnant woman should be tracked monthly to check the changes in antibody titer. If the Rh antibody titer rises from a low level to 1:32 or 1:64 or above during this pregnancy, the amniotic fluid bilirubin value increases, and the amniotic fluid phosphatidylcholine/sphingomyelin ratio is greater than 2 (indicating that the fetal lungs are mature), early delivery can be considered to reduce fetal involvement.

(2) Repeated plasma exchange: For pregnant women with severe Rh hemolytic disease whose blood Rh antibody titer continues to increase during prenatal monitoring, repeated plasma exchange treatment can be given to replace the antibodies. Reduce fetal hemolysis.

(3) Intrauterine transfusion: In cases of fetal hydrops, or fetal Hb < 80 g/L and immature lungs, intrauterine transfusion can be performed. Concentrated red blood cells that do not agglutinate with the maternal serum are directly injected into the umbilical vein under B-ultrasound monitoring.

(4) Medication: Starting from the fourth month of pregnancy, the Chinese medicine Leonurus japonicus, Chinese angelica, white peony root, and Magnolia officinalis can be taken orally, one dose per day until delivery. Pregnant women with ABO incompatibility hemolytic disease can be given Chinese medicine such as Artemisia capillaris to prevent it. Pregnant women should take phenobarbital 90 mg/d orally 1 to 2 weeks before the expected date of delivery to induce the production of fetal glucuronyl transferase.

(5) Termination of pregnancy: Pregnant women should receive comprehensive treatment to reduce antibody production, and the pregnancy should be terminated if necessary.

2. Rh-negative women should be given an intramuscular injection of 300 μg of anti-RhD IgG as soon as possible within 72 hours after the delivery of an Rh-positive baby to avoid sensitization; another intramuscular injection of 300 μg at 29 weeks of pregnancy will have a better effect.

For Rh-negative women with miscarriage, antepartum bleeding, amniocentesis or ectopic pregnancy who have received Rh-positive blood transfusion, the same dose should be injected intramuscularly.