The race to save a newborn with severe hemolysis

The medical team performed a blood exchange transfusion for the infant through the umbilical artery-vein. Photo provided by the Hospital

Earlier, the Neonatal intensive care unit at the Pediatric Center received newborn Tran T.D.T., born on November 7, 2024, from Le Xa Village, Mai Thuy Commune, Le Thuy District, Quang Binh Province. The baby exhibited signs of early jaundice immediately after birth. The doctors conducted a thorough examination and specialized tests, diagnosing severe hemolysis caused by Rh blood group incompatibility between mother and child. The mother had blood type B Rh(-) with anti-D antibodies, while the baby had blood type B Rh(+), resulting in a strongly positive Coombs test. Consequently, the infant developed rapid jaundice extending to the soles of the feet, accompanied by severe anemia and critically high bilirubin levels.

The doctors initiated urgent measures: the infant received continuous intensive phototherapy, transfusions of washed group O red blood cells, immunoglobulin, and fresh plasma. Despite these efforts, the infant's condition remained critical, with bilirubin levels exceeding the threshold for exchange transfusion (total/direct bilirubin at 388/48 µmol/L).

A multidisciplinary team from the Neonatal intensive care unit, Department of clinical hematology, with Pediatric Center directors held an emergency consultation and decided to perform a blood exchange transfusion on the baby, who was just 50 hours old, via the umbilical artery-vein.

The blood exchange was carried out with precision and intense focus. After two hours of continuous transfusion, the infant's vital signs gradually stabilized. The procedure was successful, with no complications. Continued phototherapy and immunoglobulin transfusions eventually reduced the bilirubin to safer levels. Baby T.D.T. made a full recovery and has since returned home with the family.

The baby made a full recovery and returned home with the family

For this case, every second was a race against time to save the child's life. Without timely intervention, the condition could have led to severe anemia, heart failure, and irreversible brain damage. The family shared, "We were extremely anxious about the unexpected developments at birth. Thankfully, with the timely diagnosis and professional, dedicated care of the medical team, our baby survived. We don’t know what to say except for expressing our deepest gratitude."

According to hematology experts, Rh incompatibility is a rare but extremely dangerous cause of neonatal jaundice. Without timely diagnosis and treatment, the mortality rate can reach 24%. The rapid progression of jaundice can lead to kernicterus in 13% of these cases, with 83% of affected children facing the risk of permanent neurological damage.

This condition occurs when the mother has an Rh(-) blood type, while the father and the baby have Rh(+). During pregnancy, some Rh(+) red blood cells from the fetus can enter the Rh(-) mother's bloodstream, prompting her immune system to produce antibodies against the Rh(+) cells. These antibodies can cross the placenta and enter the fetus's body, destroying its red blood cells and leading to severe hemolysis. This condition can result in severe anemia and jaundice, posing a significant risk of serious complications for the baby in the future.