Neonatal management and outcome in alloimmune hemolytic disease

Expert Review of Hematology
Isabelle M C ReeEnrico Lopriore

Abstract

Hemolytic disease of the fetus and newborn (HDFN) occurs when fetal and neonatal erythroid cells are destroyed by maternal erythrocyte alloantibodies, it leads to anemia and hydrops in the fetus, and hyperbilirubinemia and kernicterus in the newborn. Postnatal care consists of intensive phototherapy and exchange transfusions to treat severe hyperbilirubinemia and top-up transfusions to treat early and late anemia. Other postnatal complications have been reported such as thrombocytopenia, iron overload and cholestasis requiring specific management. Areas covered: This review focusses on the current neonatal management and outcome of hemolytic disease and discusses postnatal treatment options as well as literature on long-term neurodevelopmental outcome. Expert commentary: Despite major advances in neonatal management, multiple issues have to be addressed to optimize postnatal management and completely eradicate kernicterus. Except for strict adherence to guidelines, improvement could be achieved by clarifying the epidemiology and pathophysiology of HDFN. Several pharmacotherapeutic agents should be further researched as alternative treatment options in hyperbilirubinemia, including immunoglobulins, albumin, phenobarbital, metall...Continue Reading

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Citations

Jun 5, 2020·Annals of Clinical and Translational Neurology·Wenqing KangChanglian Zhu
Aug 15, 2020·British Journal of Haematology·James S CastlemanMark D Kilby
Feb 29, 2020·Prenatal Diagnosis·James S Castleman, Mark D Kilby
Oct 19, 2020·Journal of Perinatology : Official Journal of the California Perinatal Association·Mohammad Hosny AwadAbdElaziz Shabaan
Jan 27, 2021·Clinics in Laboratory Medicine·Melanie E Jackson, Jillian M Baker
Feb 17, 2021·Journal of Perinatology : Official Journal of the California Perinatal Association·Jiarong PanHuimin Yu
Feb 21, 2021·American Journal of Obstetrics & Gynecology MFM·Isabelle M C ReeEnrico Lopriore
May 18, 2021·Frontiers in Pediatrics·Rana AlissaAgnes E Aysola
Jul 3, 2021·International Journal of Environmental Research and Public Health·Mahendra Tri Arif SampurnaPieter J J Sauer
Oct 2, 2020·Journal of Pediatric Hematology/oncology·Ruyao WangNailun Su

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