Hemolytic Disease Of The Newborn

Newborn jaundice is a condition marked by high levels of bilirubin in the blood. The increased bilirubin causes the infant's skin and whites of the eyes (sclera) to look yellow.

This week of maternity clinical rotation, I had a patient Mrs. M was 35-year-old G2P2. She gave birth to a boy by cesarean section at 41 weeks. Mrs. M had Rh+ and Blood group was O+. She was rubella immune, +PPD and had no known allergies. Her GBS, HBsAg, and RPR status were negative.

There is also three other forms of hemochromatosis Juvenile, neonatal, and transfusion. “Juvenile hemochromatosis is one type of form which affects young adults ages 15 to 30.” Then there is “neonatal hemochromatosis, which is when iron builds up very quickly in an infants liver and can cause death.” The third is transfusion related hemochromatosis which is a result of “iron overload cause by to many blood transfusions.”

Procedures such as amniocentesis and chorionic villus sampling (CVS) represent the standard diagnostic methods used by clinicians to screen fetuses for abnormalities or genetic disease such as Down syndrome. In amniocentesis, a needle is inserted into the amniotic sac of the mother and a small sample of amniotic fluid is obtained. Fetal tissue is contained within the amniotic fluid and is subsequently analyzed genetically and cytogenetically for abnormalities. In the case of CVS, a sample of placental tissue is obtained through the mother’s cervix for downstream genetic analysis as in the case of amniocentesis (CDC,

Patient 1 : A 3-week-old baby is brought into the urgent care clinic with a fever of 101.4 degrees F. Without hesitating or assessing the infant, the physician orders a complete blood count (CBC), a urinalysis, blood cultures, and a lumbar puncture.

The purpose of this experiment is to identify the different blood types through the antigen and antibody reaction by using the anti- A, Anti- B and Anti- Rh serums we will be able to identify the different blood types. We will also discuss how this can be used in the clinical setting of this blood typing procedure, by doing so we will know how antigens and antibodies relate to the blood typing procedure in the real world settings.

Keia is a 31yo, G2 P0100, who is currently 9 weeks 6 days as dated by a 6-week scan that was off from her LMP. She has a history of an IUFD at 29 weeks. She reports that she had decreased fetal movement prior to coming in and there being no fetal heart tones on examination, but other than that there were no other significant precipitating events. She did have an increased risk for Down syndrome at 1:140 but per the old reports all of her analytes were within normal limits. At the time of delivery, the baby did appear to be appropriate weight and there were no obvious causes at the time of delivery. She reports that she had chromosomes performed after and the chromosomes were negative. She also thinks she had a full autopsy that was unremarkable. She did have a work-up for clotting disorders due to the history of loss and according to the chart everything is relatively within normal limits except for MTHFR which was heterozygous for C677T and A1298C. I did not see beta-2 glycoprotein or antithrombin III. Because of the relatively normal work-up she is on a baby aspirin and Metanx. She is here today to discuss her history and plans for this pregnancy.

As a general guideline, the Obstetrician orders the pertinent laboratories; aPTT, PT, H&H, CBC’s, Coagulation test, Type and cross match, AST and ALT, BUN & creatinine test. Additionally, its follow by a strict diet prior conception and during pregnancy like the consumption of iron 325mg per day to help with the production of red blood cells, and folic acid 400mg to help with production or red blood cells and decrease neural defects on newborn and intake of Vitamin B12 that helps to reproduce and maintain red blood cells and supports the development of the neurological system. Besides The communication, the patient also understands the risk factors and is more aware of the possible complications she and her fetus might face during the procedure. As we may already know, the patient has the right to refuse or accept treatment in accordance with her beliefs. As a health care professional, we have to respect and honor her wishes. As a nurse, we should not have the impression that all Jehovah’s Witness will refuse blood transfusion because not all often follow the same guidelines. Based-on that the Obstetrician works together with patient to prevent hemorrhagic episodes during and after delivery,

Immune-Mediated Hemolytic Anemia (IMHA) is one of the most severe autoimmune disorders that kills between 29-77% of dogs each year [1]. The disease is usually found in large and middle aged dogs. IMHA is a pathologic process that results in premature destruction of red blood cells when an immune response directly or indirectly targets red blood cells of all ages[ 2]. IMHA can be caused by various factors, but categorized in two ways. IMHA can be an idiopathic autoimmune event (primary IMHA) or associated with trigger factors (secondary IMHA) such as imbalance of immune cells caused by another underlying disease, toxin, drug, or vaccine [3]. The most common clinical signs of IMHA may be acute or chronic, depending upon the rate of hemolysis. If the patient is in a chronic state, they will have symptoms such as lethargy, jaundice, decreased physical activity, diarrhea, or discoloration of urine, which most mistake for a urinary tract infection. If there is a more rapid hemolysis occurring, the first symptom to happen may be an acute collapse from the dog [1]. Although the mortality rate of IMHA is fairly high, there are treatment options to improve tissue oxygen delivery and to suppress the immune response to prevent some of the major complications that occur with IMHA [1]. Depending on the severity of the patients IMHA, a blood transfusion may be required, but if not then most cases are treated with immunosuppressant therapy such as glucocorticoid therapy, adjunct

of 6 to 10 g/dL. The other values are all within the range of normal.

Hemophilia is the oldest known hereditary bleeding disorder. There are two types of hemophilia, A and B (Christmas Disease). Low levels or complete absence of a blood protein essential for clotting causes both. Patients with hemophilia A lack the blood clotting protein, factor VIII, and those with hemophilia B lack factor IX. A person with severe hemophilia has less than 1% of the normal amount of a clotting factor - either Factor VIII (8) or Factor IX (9). People without hemophilia have between 50-150% of the normal level of factor VIII or IX. There are about 20,000 hemophilia patients in the United States. Each year, about 400 babies are born with this disorder. Approximately 85% have hemophilia A and the remainder has hemophilia B.

The aim of this experiment was to determine the concentration of haemoglobin in an unknown blood sample using the haemoglobincyanide method and to adapt this method to determine percentage haemoglobin F (foetal haemoglobin) in an unknown sample, and to understand the relevance of these tests in the calculation of Hb concentration.

Hemophilia is a blood disorder that’s usually genetically inherited from parents. People born with hemophilia have little or no clotting factor – a protein needed for normal blood clotting.

Occasionally a baby is born with this disorder and no family history of it. When this happens, it could be caused by a hidden gene, which is when several generations of female carry it, and it has not affected any male members of the family or a spontaneous mutation. With each pregnancy, a woman who is a carrier has a 25% possibility of having a son born with hemophilia. Since the father's X chromosome is what determines if the unborn child will be a girl, all of the daughters born of a man with hemophilia will be carriers. None of his sons, which is determined by the father through his Y chromosome, will have hemophilia. Individuals who suffer from mild hemophilia may choose to use a non-blood product known as Desmopressin acetate (DDAVP) to help treat the small bleeds and/or scrapes. For deep cuts or internal bleeding, the treatment called DDAVP may not be enough and therefore, may need a much more complex treatment. The clotting factor must be replenished so the affected person can form a clot to stop the bleeding. Plasma is one of the ‘human blood products’ than is used for factor replacement. Another factor replacement option is using the recombinant factor, which is produced in a laboratory.

The principal mode of diagnosis is a differential diagnosis, and it includes a plethora of facets; bleeding from implantation site, which may be due to uterine atony, with predisposing factors such as infections, and retained placenta or abnormal placentation (Sheiner, 2011). Coagulation disorders and trauma are also essential facets considered during diagnosis (Sheiner, 2011). Conventionally, there are different methods used for the estimation of blood loss during diagnosis, and they are majorly classified as clinical and quantitative methods (Ricci & Kyle, 2009). Clinical method remains the primary means to