LEADING ARTICLE
Haemolytic disease
Haemolytic disease of the newborn
1 Imperial College, Department of Paediatrics, Hammersmith Hospital, London W12 0NN, UK
2 Imperial College Faculty of Medicine, Hammersmith Campus, Hammersmith Hospital, London W12 0NN, UK
Correspondence to:
Correspondence to:
Dr Neil A Murray
Senior Lecturer in Neonatal Medicine, Imperial College, Department of Paediatrics, 5th Floor, Ham House, Hammersmith Hospital, Du Cane Road, London W12 0NN, UK; neil.murray@imperial.ac.uk
The changing management of haemolytic disease of the newborn is reviewed
Keywords: haemolytic; hyperbilirubinaemia; jaundice; phototherapy
| The first 150 words of the full text of this article appear below. |
In the space of most paediatricians working lifetime, the spectrum of haemolytic disease of the newborn (HDN) has changed beyond recognition. Thirty years ago, HDN was almost synonymous with Rh D allo-immunisation and was a common neonatal problem. It was usually unmodified by antenatal therapy and caused overt fetal or neonatal haemolysis, leading to marked neonatal hyperbilirubinaemia and attendant anaemia. Affected neonates were commonly sick and unstable at birth, required multiple exchange transfusions, and suffered considerable neonatal morbidity and mortality. However, the introduction in the UK in the 1970s of routine postnatal prophylactic anti-D immunoglobulin for Rh D negative women has dramatically reduced this form of HDN, and as such this treatment ranks as one of the great success stories of modern perinatal care.
Although the clinical burden imposed on neonatal services by HDN has greatly reduced, it has not disappeared. Neonatal paediatricians continue to recognise a number
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