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Hemolytic Disease of the Newborn

  • Chapter
Handbook of Clinical Laboratory Testing During Pregnancy

Part of the book series: Current Clinical Pathology ((CCPATH))

Abstract

Hemolytic disease of the newborn (HDN) is characterized by the destruction of fetal red blood cells by maternal immunoglobulin G (IgG) directed against antigens present on fetal erythrocytes. These paternally inherited antigens are not present on maternal cells and can stimulate the maternal immune system to produce antibodies when antepartum or intrapartum fetomaternal hemorrhage occurs. Maternal sensitization often occurs during the first pregnancy with a fetus that expresses the erythrocyte antigens and although this fetus is at low risk of HDN, future antigen-positive fetuses are at substantial risk of developing the disease. Transplacental passage of the resulting antibodies into the fetal circulation often leads to hemolysis that can range from mild to extreme depending on several factors including, among others, the antibody concentration, the transfer rate of immunoglobulin from the maternal to the fetal circulation, the antibody specificity, the functional maturity of the fetal spleen, and the IgG subclass (Fig. 1) (1).

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Authors
  1. David G. Grenache PhD
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Editors and Affiliations

  1. Departments of Pathology and Immunology and Obstetrics and Gynecology, Washington University School of Medicine, and Clinical Chemistry and Serology Laboratories, Barnes-Jewish Hospital, St. Louis, MO, USA

    Ann M. Gronowski PhD, DABCC

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© 2004 Humana Press, Totowa, NJ

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Grenache, D.G. (2004). Hemolytic Disease of the Newborn. In: Gronowski, A.M. (eds) Handbook of Clinical Laboratory Testing During Pregnancy. Current Clinical Pathology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-787-1_11

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  • DOI: https://doi.org/10.1007/978-1-59259-787-1_11

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-4684-9862-2

  • Online ISBN: 978-1-59259-787-1

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