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Escola Superior de Saúde

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Browsing Escola Superior de Saúde by Subject "ABO incompatibility"

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  • Clinical case report: severe neonatal jaundice due to abo incompatibility
    Publication . Pimentel, Maria Helena; Antão, Celeste
    A clinical situation in which foetal red blood cells carrying different surface antigens pass through the placenta into the maternal circulation. Following the initial exposure, the maternal immune system produces IgM-type antibodies. A second exposure triggers the rapid and massive production of IgG antibodies, which cross the placenta and bind to the foetus's red blood cells. Since the introduction of Rh immunoglobulin (RhIG) in 1968, the incidence has decreased significantly (Harmening, 2012). This disease can cause foetal anaemia, erythropoiesis with hepatosplenomegaly, increased bilirubin due to the destruction of red blood cells. In some cases, this can be fatal.
    2025Conference object Open access Show more
  • Clinical case report: severe neonatal jaundice due to ABO incompatibility
    Publication . Pimentel, Maria Helena; Antão, Celeste
    A male newborn, delivered at 38 weeks via cesarean section due to fetal distress, weighed 2.9 kg at birth. He had low APGAR scores-4 at the 1st minute and 6 at the 5th-indicating clinical instability. He was admitted to the neonatal unit with severe jaundice, respiratory distress, and hemodynamic instability. Initial labs revealed anemia (hemoglobin 7 g/dL) and elevated indirect bilirubin. A positive direct Coombs test confirmed hemolytic anemia due to ABO incompatibility, which exacerbated the jaundice.Despite initiation of intensive phototherapy, bilirubin levels remained critically high, raising concern for bilirubin encephalopathy. Given the lack of response and risk of neurological damage, an exchange transfusion was promptly indicated. This therapeutic procedure involves replacing the infant's blood with donor blood to reduce bilirubin levels and remove maternal antibodies. The newborn was placed in a supine position, and the transfusion was performed in stages, replacing approximately 85% of his blood volume with double the volume of fresh donor blood. The procedure was carried out under continuous monitoring of vital signs, laboratory parameters, and strict hemodynamic control.
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