California Association
for
Medical Laboratory Technology

Distance Learning Program

Hemolytic Disease of the Newborn by Helen M. Sowers, M.A., CLS Department of Biological Science (retired) California State University - East Bay, Hayward, CA Course Number: DL-995 1 .0 CE/Contact Hour Level of Difficulty: Basic © California Association for Medical Laboratory Technology. Permission to reprint any part of these materials, other than for credit from CAMLT, must be obtained in writing from the CAMLT Executive Office. CAMLT is approved by the California Department of Health Services as a CA CLS Accrediting Agency (#0021) and this course is is approved by ASCLS for the P.A.C.E.® Program (#519) 1895 Mowry Ave, Suite 112 Fremont, CA 94538-1766 Phone: 510-792-4441 FAX:  510-792-3045 Notification of Distance Learning Deadline All continuing education units required to renew your license must be earned no later than the expiration date printed on your license. If some of your units are made up of Distance Learning courses, please allow yourself enough time to retake the test in the event you do not pass on the first attempt. CAMLT urges you to earn your CE units early!.

This course is configured to be completed on-line. You can register for the course, submit secure payment using a credit card via PayPal, take the quiz on-line and receive your graded score.   If you pass, your certificate will be mailed to you from the CAMLT office. If you fail, you must submit new payment and obtain a new PayPal receipt each time you take the test.   A certificate will be issued only if you have paid for re-taking the course and you pass the test. If you want to submit your registration and quiz via fax or mail you should print the Adobe Acrobat version of the course which includes the required Registration/Quiz form.

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Hemolytic Disease of the Newborn

Completion of this course requires downloading the Acrobat Version (link above).
You may then print a copy or view the downloaded file on your computer to see the course material.
Only the Objectives and Introduction appear below.

OBJECTIVES:

1. Summarize the history of Rh-Hemolytic Disease of the Newborn (HDN)
2. Outline the model of Rh-HDN
3. Explain the cause of ABO-HDN and contrast to Rh-HDN
4. State the racial differences in incidence of the Rh negative gene
5. Discuss the conditions that affect the sensitization of the mother to the Rh antigen.
6. Discuss the symptoms of HDN
7. Outline the treatment options for the fetus and newborn with HDN
8. List the tests for HDN done on the mother, fetus, and newborn

INTRODUCTION:
In the past Hemolytic Disease of the Newborn (HDN) was a major cause of death and disability in Caucasian fetuses and newborn infants.  The condition occurs when an infant has a RBC antigen, inherited from the father, that the mother lacks, and she produces IgG antibodies to this antigen.  These antibodies in the mother cross the placenta and cause destruction of red blood cells in the fetus.  The infant develops anemia in utero that may lead to hydrops fetalis (severe edema) and other problems.  After birth the infant may develop jaundice due to accumulation of bilirubin from continued hemolysis of RBCs.
Formerly the most common cause of HDN was Rh (D) incompatibility.  It wasn’t until this blood group antigen was identified in 1940, and then associated with HDN in 1941, that the pathogenesis was described.  By the late1960s this led to the use of therapeutic antibodies to prevent sensitization of the Rh-negative mother by the infant’s RBCs.  Now all Rh-negative mothers at risk of becoming sensitized are given anti-Rh (D) antibodies during pregnancy and at the time of delivery.
At present the most common cause of HDN is ABO incompatibility, with Rh (D) next.  Other blood groups are less frequent causes of HDN.

Laboratory testing plays a crucial role in the identification of at-risk pregnancies, the prophylaxis of HDN, the diagnosis of the disease, and the identification of the antibody causing the problem.