Hämolytische Erkrankung des Fetus und Neugeborenen

Die Schwangerschaftskomplikation „Hämolytische Erkrankung des Fetus und Neugeborenen“ kann unbehandelt zum Kindstod führen. Lesen Sie in Teil 1 des Beitrags über Ätiologie, Pathogenese, Diagnostik und Therapie in der Schwangerschaft. Der Teil 2 stellt die Diagnose und Therapie der hämolytischen Erkrankung des Neugeborenen sowie die Primärprophylaxe vor.

Kernaussagen

• Während der Schwangerschaft kann die werdende Mutter Antikörper gegen Antigene auf fetalen Erythrozyten bilden.

• Die fetale hämolytische Anämie wird durch maternale IgG-Antikörper bei fetomaternaler Blutgruppeninkompatibilität hervorgerufen.

• Fortschritte in der Pränatalmedizin, der Neonatologie und Transfusionsmedizin führten in den letzten Jahren zu einem Paradigmenwechsel: Die frühzeitige Erkennung von Risikoschwangerschaften, Komplikationen und deren Management erfolgt heute weitgehend nicht invasiv.

• Bei der Diagnostik der fetalen Anämie durch Doppler-Sonografie wird sich der Zusammenhang zwischen fetalem Hämatokrit und der Blutflussgeschwindigkeit in fetalen Gefäßen zunutze gemacht.

• Hydrops fetalis ist eine Manifestation von Morbus haemolyticus fetalis.

• Unbehandelt kann die seltene Schwangerschaftskomplikation „hämolytische Erkrankung des Fetus und Neugeborenen“ zum Kindstod führen.

• Bei einer behandlungsbedürftigen fetalen Anämie ist die intrauterine Bluttransfusion die einzige therapeutische Option.

Schlüsselwörter

fetale Anämie - fetaler Hydrops - intrauterine Transfusion - erythrozytäre Antikörper - molekulargenetische Blutgruppenbestimmung, hämolytische Erkrankung des Fetus und Neugeborenen

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