Its about hemolytic reactions ...

2. Erythroblastosis
Erythroblasts …. Immature RBCs.
Erythrocytes…….Mature RBCs
 Erythroblastosis…. Breakdown of immature
RBCs

3. Erythroblasts and Erythrocytes

4. Autoimmunization
An immune response to foreign antigens after
exposure to genetically different cells or
tissues.
Undesirable outcome of a blood transfusion.
Autoantibodies
Alloantibodies

5. Autoantibodies
React with self-molecules occur in healthy
individuals and are referred to as natural
antibodies or autoantibodies.
Alloantibodies
 Produced by an individual with allo-antigen
which is foreign antigen from other individual
of same species.

6. Allo-antibodies
Which may occur as a result of from
Wrong transfusion
Transplantation
Mixing of blood during pregnancy

7. Hemolytic Reactions
Acute transfusion reaction… Caused by ABO
antibodies.Rapid Destruction of RBCs.
Delayed transfusion reaction….occurs after 24
hours of blood transfusion.
Hemolytic Disease of newborn …. In which
mothers’s alloantibodies reacts against feotus
antigens and destroy their immature RBCs
known as erythroblasts

8. Rh blood group system
Named after the Rhesus monkey, which is the
animal where it was first identified.
 depends on the presence or absence of the
Rh antigen.Rh factor can be either present (+)
or absent (-) and is referred to as Rh positive if
a person have the Rh factor or Rh negative if
Rh factor is not present.

10. Importance
Rh blood group doesn’t contain any antibody
against the Rh antigen,unless the body is
stimulated by exposure to Rh antigen.
Rh negative person contains neither Rh
antigen on its cells nor Rh antibody in its
plasma.

12. Erythroblastosis Fetalis
Hemolytic anemia and it occurs
during transplacental transmission of
maternal antibodies to fetal RBCs.
The disorder usually results from
incompatibility between maternal
and fetal blood groups.

13. Rh Incompatibilty
Rh (-) woman + Rh (+) man = Rh (+) children
 Rh positive feotus cross the placental barrier
and enter into Rh negative mother’s blood
stream.
 mother’s immue system reacts feotal Rh
antigen stimulus by producing a large number
of anti-Rh antibodies.
 mother’s antibodies + feotus RBCs=hemolysis

15. Symptoms
Anemia
 Mother’s antibodies destroy baby's RBCs and
the baby develops anemia.
 The baby's body tries to compensate for the
anemia by releasing immature RBCs called
erythroblasts from the bone marrow.
 Liver and spleen to become enlarged
potentially causing liver damage or a ruptured
spleen.

16. Jaundice
Infants have high levels of bilirubin in
their blood ,which leads to jaundice.
(hyperbillirubinemia)
Shorter life span of RBCs
Unconjugated billirubin binds to
albumin travels to liver.
Increase reabsorption of conjugated
billirubin from GI tract.

19. Kernicterus
• Free bilirubin is lipid soluble.
• Deposited in brain.
• It causes a condition known as
Kernicterus.

21. Diagnosis
Routine blood Test
Feotus Blood Test
Indirect Coombs Test
Direct Coombs Test

22. Direct Coombs test or DAT
RBCs wash to remove plasma
RBCs are incubated with anti-
hemoglobulin.
Antihemoglobulin binds to patient’s
antibodies that are attached with RBCs
Agglutation indicates positive DAT.

28. Indirect coombs test or IDT
• The IDT deals with extracted plasma.
• Unbound antibodies remains in blood
• Plasma is then incubated with reagent RBCs.
• Antibodies binds to reagent RBCs.
• Positivr IDT indicates presence of antibodies in
blood.

32. Treatment
Rho-GAM
Gamma Globulin
Outside source of antibodies
Administrated 28th week of
pregnancy
After 72 hours of Delivery.

33. Vaccination
• Rho-gam works
almost like
vaccination
• Vaccination is dosage
of a virus that is too
small to cause serious
illness.
• Enables body to fight
against virus or any
foreign paticle.

34. RhoGam vaccination
• Contains antibodies
to RH (+)
• But not harmfull
enough
• Mother’s body
react to these
antibodies and
never reacts to fetal
antibodies.

35. Amniocentesis
• Amniotic fluid test which is
performed to test fetal infections and
also for sex determination.
• Rho-GAM is also given after
amniocentesis.

36. Intrauterine blood transfusion
• Given to replace fetal RBCs that are being
destroyed by mother’s alloantibodies.
• Keep the fetus healthy until he or she is
mature enough to be delivered.
• Umbilical vein or artery… Umbilical cord
vessel
• Permits absorption of blood.

37. Procedure
 position of placenta through
ultrasound image.
Antiseptic solution to clean mother’s
abdomen
Anesthetic injection to make
abdominal region insensitive
Needle is inserted

38. Intrauterine-blood transfusion
 mother's abdomen into the fetus's
abdomen or an umbilical cord vein.
A compatible blood type is delivered
into the fetus's umbilical cord vessel.