Hemolytic disease of the newborn (HDN) is a condition that occurs when a mother’s and baby’s blood types are incompatible. It is the result of an antibody produced by the mother that enters the baby's bloodstream and causes the baby's red blood cells (RBCs) to be destroyed. The condition can be mild to severe, and can lead to anemia, jaundice, and other serious complications.
Differentials for HDN
The main differentials for HDN are:
Rh incompatibility: Rh incompatibility occurs when the mother is Rh negative and the baby is Rh positive. The mother's body produces antibodies to the Rh antigens found on the baby's RBCs, which can lead to HDN. Rh incompatibility is the most common cause of HDN.
ABO incompatibility: ABO incompatibility occurs when the mother is O positive and the baby is A or B positive. This can result in the mother's body producing antibodies against the antigens on the baby's RBCs, leading to HDN. ABO incompatibility is the second most common cause of HDN.
Kell incompatibility: Kell incompatibility occurs when the mother is Kell positive and the baby is Kell negative. This can result in the mother's body producing antibodies against the antigens on the baby's RBCs, leading to HDN. Kell incompatibility is the third most common cause of HDN.
Other causes: There are other less common causes of HDN, such as Duffy incompatibility, Kidd incompatibility, and Lewis incompatibility. These are usually the result of an antibody produced by the mother that enters the baby's bloodstream and causes the baby's RBCs to be destroyed.
Diagnosis and Treatment of HDN
HDN can be diagnosed through blood tests. The blood tests can detect antibodies in the mother's and baby's blood that indicate the presence of HDN. If HDN is suspected, the baby may be monitored for signs and symptoms of HDN, such as anemia, jaundice, and other complications.
Treatment for HDN depends on the severity of the condition. In mild cases, treatment may include monitoring the baby's condition and providing supportive care, such as phototherapy for jaundice. In more severe cases, treatment may include a blood transfusion or exchange transfusion to replace the baby's RBCs with healthy ones.
