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Took AKT 2 during pregnancy. Baby and mother has ABO incompatibility. Why elevated blood test report?

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Posted on Wed, 6 Mar 2013
Question: newborn blood platelets , bilirubin high and low Hb and RBC countsir my baby boy born on 23/1/2013 ,his blood group is A+ and mother's O+ . mother has gestational blood sugar with high level of anti TPO . she took AKT 2 during pregnancy.
now abt my son , imidiate after birth doc moves him in child hospital. from second day his blood report
Dt. bili Hb. RBC. platelete
24/1. 9.6. 13.1. 3.72. 312
26/1. 14.4
27/1. 14.1
29/1. 17.3. 11.0 3.12. 593
30/1. 13.1
3/2 13.5
6/2 13.7. 9.8. 2.78. 620
baby and mom have ABO incompatibility . I want to know y RBC , Hb going down and Platelets going high and bili level not going down . pls make me understand abt this situation , and tell me is this really worry for me
doctor
Answered by Dr. Luchuo Engelbert Bain (2 hours later)
Hi,
Knowing that there exists ABO incompatibility is the major step in the interpretation of these results. Considering that the platelet count continues to increase is a normal reaction of the body. The cells which produce red blood cells also produce platelets, but the red blood cells are destroyed due to incompatibility. The red bone marrow that produces the cells are stimulated more to produce red blood cells, and since they also produce platelets, platelets continue rising, but the hemoglobin levels fall because they (the RBC’s) are destroyed by these antibodies.
Bilirubin is a product from the metabolism of heme, an iron containing substance in the red blood cells. This molecule is responsible to carry oxygen. As red blood cells are destroyed, this substance was released into blood and metabolized to produce bilirubin, reason why its levels were high. The continued decrease in the levels of hemoglobin and red blood cells indicate that there is still an activity against the destruction/hemolysis of the child s red blood cells.
A re-evaluation has to be made, other blood tests like Coombs exact test could be performed to detect presence of irregular antibodies. We could also conduct these tests in another laboratory or repeat the tests in the same lab for errors do occur at times. A reevaluation by pediatrician or neonatologist is also important to know whether the child should be considered for phototherapy, a procedure to reduce bilirubin in blood, which at very high levels, could be toxic to the child s nervous system leading to Kernicterus, a serious brain condition.
However, the results for now are not too alarming, deserves reevaluation and reorganization of the treatment plan.
Hope this helps,
Luchuo, MD.

Above answer was peer-reviewed by : Dr. Aparna Kohli
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Answered by
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Dr. Luchuo Engelbert Bain

General & Family Physician

Practicing since :2009

Answered : 3092 Questions

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Took AKT 2 during pregnancy. Baby and mother has ABO incompatibility. Why elevated blood test report?

Hi,
Knowing that there exists ABO incompatibility is the major step in the interpretation of these results. Considering that the platelet count continues to increase is a normal reaction of the body. The cells which produce red blood cells also produce platelets, but the red blood cells are destroyed due to incompatibility. The red bone marrow that produces the cells are stimulated more to produce red blood cells, and since they also produce platelets, platelets continue rising, but the hemoglobin levels fall because they (the RBC’s) are destroyed by these antibodies.
Bilirubin is a product from the metabolism of heme, an iron containing substance in the red blood cells. This molecule is responsible to carry oxygen. As red blood cells are destroyed, this substance was released into blood and metabolized to produce bilirubin, reason why its levels were high. The continued decrease in the levels of hemoglobin and red blood cells indicate that there is still an activity against the destruction/hemolysis of the child s red blood cells.
A re-evaluation has to be made, other blood tests like Coombs exact test could be performed to detect presence of irregular antibodies. We could also conduct these tests in another laboratory or repeat the tests in the same lab for errors do occur at times. A reevaluation by pediatrician or neonatologist is also important to know whether the child should be considered for phototherapy, a procedure to reduce bilirubin in blood, which at very high levels, could be toxic to the child s nervous system leading to Kernicterus, a serious brain condition.
However, the results for now are not too alarming, deserves reevaluation and reorganization of the treatment plan.
Hope this helps,
Luchuo, MD.