Quanzhou newborn baby Xiaodong (pseudonym)
In the case of hemolytic jaundice in newborns,
Edema of the whole body, life hanging on the line,
And Xiaodong's mother's blood type
It is a negative rare blood type (commonly known as "panda blood").
fortunately
Quanzhou Maternal and Child Health Hospital and Children's Hospital
Neonatal plasma exchange is performed by neonatal health care workers,
Snatched this "panda blood" baby back from the hands of death.
It is reported that this is the first time that the Children's Hospital of Quanzhou Maternal and Child Health Hospital has applied plasma exchange technology to rare blood type hemolytic newborns born only 2 hours ago, and the successful treatment of this case has improved the level of regional neonatal plasma exchange technology and accumulated valuable experience.
Become a "minion" at birth
Relay of Life to replace plasma
Not long ago, Ms. Liu's family, who lives in Quanzhou, welcomed the newborn baby Xiaodong. When the family was immersed in joy, Ms. Liu found that Xiaodong's skin, which was only 2 hours old, began to appear mucosal yellow, like a "minion".
After that, Xiao Dong's face became worse and worse, and his breathing was short. Soon, because of his complicated condition, Xiaodong was urgently sent to the intensive care unit of the Neonatal Department of Quanzhou Maternal and Child Health Hospital and Children's Hospital.
After examination, Xiaodong was diagnosed with hemolytic jaundice in newborns, and his blood biochemical results suggested that bilirubin 289umol/L had exceeded the transfusion index.
After the first collective consultation, the neonatal medical team decided to perform peripheral arteriovenous synchronous transfusion for Xiaodong immediately, and bilirubin continued to rise to 401umol/L after exchange change, and was given transfusion treatment again, but after two blood exchanges, the effect was not good, and bilirubin remained high.
Xiaodong's life was in danger, and Chen Dongmei, the leader of the Neonatal Science Department of Quanzhou Maternal and Child Health Hospital and Children's Hospital, immediately convened a team of doctors, held a collective consultation, and performed plasma exchange for Xiaodong with the consent of his family.
It is understood that the so-called plasma exchange is to lead the patient's blood out of the body, through the membrane plasma separation method to separate the patient's plasma from the whole blood and discarded, and then supplement the same amount of fresh frozen plasma or human blood albumin and other replacement solutions, so that the patient's body can be removed from various metabolic toxins and pathogenic factors, so as to achieve the purpose of treatment.
After two tense "plasma exchange" treatments that lasted 4 hours, the medical team successfully exchanged 730 ml of plasma for Xiaodong, and the jaundice index of the child gradually decreased, and the hemoglobin and total bilirubin returned to the safe range.
Guarded day and night for 37 days
The Minions are reborn
After successful plasma exchange, Xiaodong turned the crisis into safety, but due to various factors such as rapid changes in the newborn's condition, poor resistance and individual weakness, the road to yellowing of the "minion" continued.
After 37 days and nights of guarding by the medical team, the yellow skin of the child has not been repeated, the indicators are stable, and he has been successfully discharged from the hospital.
Neonatal hemolytic disease is a fetal or neonatal immune hemolytic disease caused by maternal and infant blood group incompatibility, clinically with fetal edema and /or jaundice, anemia as the main manifestations, severe cases can cause death or leave serious sequelae.
The most common blood group incompatibility hemolysis is ABO incompatibility, followed by Rh blood group incompatibility.
Plasma exchange method can not only remove bilirubin, but also remove antigen antibodies and complexes in the body of such hemolytic children, reduce the continued occurrence of hemolysis, and the traditional method of blood exchange, this method reduces the waste of platelets, red blood cells, coagulation factors, reduces unnecessary blood product intake, and the whole process of hemodynamic stability.
Chen Dongmei said:
The Department of Neonatology of Children's Hospital of Quanzhou Maternal and Child Health Hospital has carried out 5 cases of plasmapheresis surgery, which is the first case of plasma exchange technology applied to neonatal hemolytic jaundice.
Neonatal plasmapheresis technology is not carried out much in China, and the successful development of neonatal plasma exchange technology has opened up a new path for neonatal blood purification treatment, and has also opened up another way for the treatment of more rare blood type hemolysis children, bringing the gospel to more children. At the same time, it marks that the hospital's treatment technology for critically ill newborns has reached the domestic advanced level.
How to prevent hemolysis in newborns?
Chen Dongmei said,
Neonatal hemolysis prevention is greater than cure,
Defend against the threat of neonatal hemolysis,
It is recommended to do the following:
First of all, we must pay attention to the prenatal examination of expectant mothers, especially blood group testing, for rh-negative blood group pregnant women with previous blood transfusions, stillbirths, miscarriages and delivery history, if the incidence of hemolytic disease is higher after testing, early delivery can be considered in the case that fetal development has reached the delivery condition.
In addition, if it is a pregnant woman with Rh-negative blood or ABO blood group incompatibility hemolytic disease, the prevention of neonatal hemolysis can be considered to use related drugs, and the specific use method should be selected under the advice of a doctor.
It is recommended that women with risk factors for blood type incompatibility (such as Rh-negative blood or O blood) pay special attention to antibody titer testing during pregnancy testing, so that they can grasp the fetal situation at any time.
If there is a high-risk neonatal hemolytic tendency, pregnant women should give birth in a hospital with neonatal rescue capacity conditions and make corresponding preparations at the time of delivery. With the advancement of medicine, it is not difficult to treat neonatal hemolysis.
Tips
There are two types of maternal and infant blood group incompatibility:
1. ABO blood type incompatibility
Mother type O, father type A, B or AB type, then the fetus is the same as the mother, it is fine. If the fetus is the same as the father, the mother may produce antibodies against the fetal blood cells and enter the fetus through the placenta, together with the destruction of fetal red blood cells, resulting in hemolysis. It is possible to develop the disease in the first child, and this condition will worsen the condition as the number of pregnancies increases, but it is not common to all mothers with blood type O, depending on the amount of antibodies in the mother's body.
2. RH blood type incompatibility
If the mother is RH negative and the fetus is RH positive, then the red blood cells with RH-positive antigens will enter the maternal blood through the placenta, producing the corresponding blood group antibodies, which in turn enter the fetal blood circulation through the placenta, acting on red blood cells, resulting in hemolysis, generally the first birth Of this situation is less, and women with multiple pregnancies are prone to hemolysis.
ABO hemolysis is relatively common in China.
Fujian Health Daily all-media reporter: Zhang Hongpeng/Wen
Correspondent: Huang Liwen
Source: Fujian Health News