We often see patients with neonatal hemolysis in the neonatal intensive care unit, and parents think why would my child suffer from this disease, neonatal hemolysis sounds like a very professional term, and because of this, it is a big killer to the health of newborn babies, so we need to know the truth about it in order to do the best prevention and effective prevention. Neonatal hemolysis refers to the hemolysis caused by mother-infant blood type incompatibility, the immune antibody IgG to fetal red blood cells in the mother’s blood through the placenta into the fetal blood circulation, and the occurrence of the same kind of immune reaction. There are many causes of hemolytic diseases in the neonatal period, among which hemolytic diseases caused by maternal and infant blood group incompatibility are more common, especially ABO system blood group incompatibility is the most common. What is ABO hemolytic disease? 1, ABO blood group classification ABO blood group classification is mainly according to the presence or absence of A, B blood group antigen on red blood cells to be divided, that is, red blood cells on only A antigen is called A type, red blood cells on only B antigen is called B type, red blood cells on no A, B antigen is called O type, red blood cells on A and B antigen is called AB type. 2, ABO blood group incompatibility hemolytic disease causes ABO blood group incompatibility hemolytic disease often occurs when the mother’s blood type is O, and the father’s blood type is A, B and AB. The blood type of the fetus is determined by a combination of genes passed from each parent, so the blood type of the fetus may be different from that of the mother. For example, if a mother with O blood type carries a fetus with A blood type inherited from the father, because the mother with O blood type does not have A antigen in her body, when the red blood cells of the A fetus enter the mother’s body, the mother’s body will produce anti-A antibodies, which will cause the destruction of the baby’s red blood cells and hemolysis. 3.Factors related to hemolytic disease but not all babies born to O blood type mothers will develop hemolytic disease, but some babies will develop and some babies will not, some have mild symptoms and some have severe symptoms. This is related to the amount of antibodies of the mother, the degree of binding of the antibodies to the fetal red blood cells, the strength of the A(B) antigen and the compensatory hematopoietic capacity of the fetus. 4, nature-induced hemolysis ABO hemolytic disease can often occur in the first child, due to the existence of substances similar to A (B) antigen in nature, O blood type mothers are often exposed to before pregnancy, and then these similar blood type antigen substances can stimulate O blood type mothers to produce A (B) antibodies, when the mother is pregnant this antibody can enter the fetus through the placenta and cause hemolysis. What are the clinical manifestations of a baby with hemolytic disease? 1. Yellowing of the skin and sclera in babies with hemolytic disease, the skin and sclera (commonly known as white eyes) are obviously yellow, often appearing within 24 hours after birth or on the second day, and rapidly worsening within 48 hours, with a sharp increase in serum bilirubin concentration of more than 12-15 mg/dl, or even up to 20 mg/dl or more. 2, anemia children have varying degrees of anemia, serious cases can cause heart failure, generalized swelling. 3, hepatosplenomegaly in mild cases without obvious enlargement, but in severe cases of fetal edema there is obvious enlargement of the liver and spleen 4, neurological symptoms appear drowsiness, refusal of milk, limb flaccidity, followed by convulsions, manifested by two eye gaze, blinking suit, limb paroxysmal stiffening and straightening, or generalized corneal inversion, sometimes screaming and other manifestations are called nuclear jaundice or bilirubin encephalopathy, often occurs when the serum bilirubin reaches 20mg / dl or more, is due to indirect bilirubin into This is due to indirect bilirubin entering the brain tissue and damaging the brain cells. 5, fever hemolysis children are often accompanied by fever. Which mothers may give birth to babies with ABO blood group incompatibility? 1.History of spontaneous abortion and jaundice in the previous birth. 2.Blood type test is O, and her husband is A, B or AB. 3.Mothers-to-be with O blood type have high potency of anti-A or anti-B antibodies before pregnancy. 4.Mothers-to-be with blood type O have anti-A (B) IgG potency >1:64 during pregnancy. 5. Ultrasound examination during pregnancy, fetal skin edema and hepatosplenomegaly can be seen in severe hemolysis. How to treat ABO hemolytic disease? A. Newborn babies should do all the work when they are first born. a. At the time of delivery, we should prepare for the rescue of newborns. 1, the fetus is delivered immediately break the umbilical cord to reduce the antibody into the baby’s body. 2, retain the umbilical cord for blood exchange in children with severe hemolytic disease. Treatment of neonatal hemolytic disease: ABO hemolytic disease is mainly manifested by jaundice, hepatosplenomegaly and anemia. The clinical symptoms vary greatly in severity, and the milder ones are often similar to physiological jaundice in newborns, while the severe ones can have obvious symptoms. After birth, newborns should be closely observed for the appearance of jaundice, usually the second to third day, and in severe cases within 24 hours, and to pay attention to the rate of jaundice deepening, such as bilirubin concentration is too high, not timely treatment can cause bilirubin encephalopathy, later affecting intelligence, so ABO hemolytic disease should be treated early. 1, light therapy: light therapy is the most simple and effective way to treat neonatal jaundice, it has the advantage of fast jaundice, less side effects, skin jaundice after receiving light bilirubin can be broken down into water-soluble, from the intestine, urine out of the body, thus reducing the concentration of bilirubin in the blood, can avoid the occurrence of bilirubin encephalopathy. Side effects: Some babies may have a transient rash and an increase in the number of stools and other minor side effects during light therapy, but these symptoms do not need to be dealt with and can heal on their own after stopping the light. 2, drug treatment: jaundice more serious can be repeated several times light therapy, while adding drug therapy. Available drugs to inhibit the antigenic reaction to reduce continued hemolysis, active hepatocyte enzyme system, can accelerate the metabolism and excretion of bilirubin or prevent the reabsorption of bilirubin in the intestinal tract and Chinese herbal medicine bile to reduce yellowing. 3. Iron supplementation or blood transfusion: Most babies with ABO hemolytic disease do not need blood exchange, and the prognosis is good after active treatment. ABO hemolytic disease in newborns is often accompanied by anemia, the degree of which is consistent with the degree of hemolysis. Mild hemolysis is often associated with mild anemia, while children with severe hemolysis may have severe anemia, which can be treated accordingly with iron supplements or blood transfusions depending on the degree of anemia. I think that by understanding this disease, the healing of the disease will be clearer, and when the disease occurs in children, it should be treated in a timely manner.