I nausen piang lai thisen chi hi i thisen nen a inmil lo em ni? (Erythroblastosis Fetalis) Hei hi eng nge a nih chiang takin i zawng chhuak ang u!

Nu ni tur i nih chuan ‘Erythroblastosis Fetalis’ tih thumal i hriat khan i hlau deuh mai thei. A nih loh leh i doctor hian rei vak lo kalta khan i thisen chi a sawi lai khan a sawi a ni mai thei. He hming hi hriat hi a hlauhawm deuh thei. Mahse lungngai suh, vawiinah hian i hriatthiam theih tur awlsam takin kan sawi dawn a ni. Eng nge a nih, engvangin nge a lo awm a, engtin nge he dinhmun lakah hian kan inven theih ang tih i lo en ang u.

‘Erythroblastosis Fetalis’ tih hi eng nge ni?

A awlsam zawngin sawi ila, hei hi a tlem hle a, mi zawng zawngin an vei lo tihna a ni a, naupai laia lo awm thei complication a ni. Hei hi i naute piang lai nen hian thisen chi hrang hrang inrem lohna a awm chuan a thleng thin. Thisen chi hrang hrang hian harsatna a thlen vek lo. Mahse, he hlauhawmna hi a bik takin i thisen chi hrang hrang `Rh-negative` leh i naute thisen chi hrang hrang `Rh-positive` a nih chuan a sang hle.

Ngaihtuah teh, he Rh-positive thisen hi, naupai hmasa emaw, thisen pek lai emaw khan i tawk a nih chuan, i taksa immune system (natna laka min humhimtu system) chuan naute thisen sen (red blood cells) chu a rawn bei tan thei a ni. Hmelma beih ang maiin. Hei hian naute thisen sen (red blood cells) chu hlauhawm takin a ti hniam thei a ni. Hei hi thisen tlakchhamna (anemia) kan ti a. He thisen tlakchhamna hi a nasat chuan enkawl loh chuan naute tan nunna atana hlauhawm tak a ni thei.

Mahse, chanchin lawmawm a awm! Tunlai hian naupai tirh lamah routine test hmangin i thisen chi hrang hrang a hriat theih. Rh-negative i nih chuan doctor ten he harsatna hi ven nan damdawi an pe thei che a ni.

Hetiang dinhmun hi `(nausen piang tharte alloimmune hemolytic disease - HDN)` leh `(nausen leh nausen piang tharte hemolytic disease - HFDN)` an ti bawk. Mahse kan sawi dawn chuan `(Erythroblastosis Fetalis)` tih hi kan hmang dawn a ni.

Naute hian hetiang natna hi a neih chuan eng symptoms nge a neih?

Hetiang natna (Erythroblastosis Fetalis) nei naute piangte hian thisen tlakchhamna chhinchhiahna an nei thei a ni. Nausen thenkhat chuan na lo takin an nei thei a, thenkhat erawh chuan na takin an nei thei thung. Tin, naute hian a pian atanga darkar 24 chhungin jaundice a nei thei bawk. A lan chhuah dan thenkhat chu hetiang hi a ni:

• Mit leh vun a sen (yellowing) thin.
• Vun a rawn sen nghal zung zung.
• Naute chu a lethargic hle a, nunna nei lo (lethargy) a ni.
• Thinlung chu a thawk chak hle (tachycardia).
• Duhthusamin bawnghnute ei duh lohna.

Nausen na tak thenkhatah chuan nausen emaw nausen piang thar emaw hian nunna atana hlauhawm tak ``hydrops fetalis'' an tih chu a nei thei a ni.A natna lan chhuah dan chu:

• Taksa a hring chhuak.
• Naute pum chhungah emaw, taksa peng pawimawh tak tak, thinlung leh lungte inkarah emaw tui awmkhawm.

Engvangin nge hetiang hi a lo awm? A chhan engte nge ni?

Hetiang dinhmun, ``Erythroblastosis Fetalis'' tia koh hi a lo awm chhan chu, a hmaa kan sawi tawh ang khan i taksa immune system hian naute thisen sen (red blood cells) a bei vang a ni.

Kan thisen sen (red blood cells) te hian marker bik an nei a. ``Antigens'' kan ti a, heng ``antigens'' te hi hming ziakna label angin ngaihtuah rawh. I immune system hian he label hi a hriat chuan chu thisen sen te chu a bei dawn lo.

Hei hi nang leh i naute thisen inthlauhna vang a ni. Thisen chi hrang hrang hi thisen sen chunglama ``antigens`` awm dan atanga thliar hran a ni. Thisen chi hrang hrang kan sawi tum ber pahnih a awm a, chungte chu:

• Rh factor: Hei hian thisen chu positive (+) nge negative (-) tihna a ni.
• ABO antigens: Hei hian thisen chi A, B, AB, O tihna a ni.

Naupai i nih chuan i immune system, i naute thisen sen chunga ``antigens`` awmte a hriat loh chuan anmahni dotu ``antigens`` a siam tan ang. Heng ``antibodies`` te hi chu thisen sen (red blood cells) te beitu an ni. Kan taksain natna thlentu hrik a neih ang chiah hian kan taksain a do thin. Mahse hei hi a lo thlen theih nan chuan naute thisen chu i thisen nen a inzawm a ngai a ni. A tam zawkah chuan hetiang hi naute pian dawn lai a thleng thin. Mahse, a chang chuan thisen chu a inhmeh hmain a inhmeh thei. Entir nan:

• Nau pai a nih chuan.
• Naupai lai a chanve vel a bo chuan ``Miscarriage`` an ti thin.
• Ectopic pregnancy ang dinhmunah (naupai chu nausen pum pawnah a awm a, fallopian tube-ah ang chi a ni).
• ``(Amniocentesis)`` (naupai laiin test tih) tih hunah.
• `(Chorionic villus sampling)` (naupai test dang) tih hunah.

I taksain heng `(antibodies)` te hi a siam chhuah tawh chuan a hre reng thin. Nausen thisen sen (red blood cells) te hian chu `(antigen)` chu a naupai leh hunah an neih leh chuan heng `(antibody)` te hian chu cell te chu an kal a, an tichhia ang. Hei hi thisen sen tihchhiatna hi `(hemolysis)` kan ti a.

A chhan ber: Rh inmil lohna

Hetiang natna thlentu na ber leh hriat lar ber chu Rh-negative i nih lai leh i naute Rh-positive a nih hian a ni. Chutiang a nih chuan i immune system chuan i naute Rh-positive red blood cells chu a bei thin. America ang ramah chuan mi 15% velin Rh-negative thisen an nei a. A tam zawkah chuan nu leh pa bakah naute pawh Rh-positive an ni.

A tlangpuiin he Rh incompatibility hian naupai hmasa berah harsatna lian tham a thlen lo. Rh-negative i nih a, naute chu Rh-positive ni mahse, naupai laiin i thisen chu naute thisen nen a inhmeh a, chu chuan reaction na tak (antibodies) a thlen thin. Mahse, naute a lo pian veleh i thisen hian naute thisen nen a inrem ngei ang. Chutih lai chuan i immune system-in a beih loh nan damdawi i ei loh chuan i taksain Rh-positive red blood cells laka antibody a siam thei a ni.

Tichuan i naupai leh a, chu naute pawhin Rh-positive blood type a neih chuan, chu antibodies siam hmasak tawhte chuan chu naute thisen sen (red blood cells) chu a kal ang. I hrethiam em?

Thisen chi hrang hrang inmil lohna hmuh tur awm lo dang

A châng chuan, i immune system hian i naute thisen sen (red blood cells) chu a bei thei a, chu chu thisen sen antigen hmuh tur awm lo tak nen a inmil lo hle a ni. Hei hi i naute hian chu antigen hmuh tur awm lo tak chu a neih a, i hloh chuan a thleng thin. Hei hi naupai hmasa emaw thisen pek emaw hmanga chu antigen i tawk tawh a, chu antibody i siam chhuah chuan a thleng thin. Chung antigen thenkhat chu:

• `(Colton)`
• `(Duffy)`
• `(Diego)` tih a ni
• `(Ee)` tih a ni
• `(Gerbich)` tih a ni
• `(H)` tih a ni
• `(Kell)` tih a ni
• `(Naupang)`
• `(Lutheran)`
• `(MNS)` tih a ni
• `(P)` tih a ni
• `(Xg)` tih a ni

Naupai tirh lama thisen test hian heng thisen sen chi hrang hrang hmuh tur awm lo tak takte laka antibody i siam leh siam loh a hriat theih.

Hetiang dinhmun hi engtiang chiahin nge a awm?

Khawvel pumah nau piang nung 100,000 zinga 276 vel chu Rh thisen chi inrem lohna nena inzawm naupai harsatna an nei nia sawi a ni. Zirchiangtute sawi dan chuan enkawl loh a nih chuan nausen piang lai chu a thih emaw, hriselna lama harsatna lian tak a neih emaw theihna chance 50% a awm a ni.

Mahse, lungngai suh! Thisen chi test leh damdawi mamawh te hmangin a rah chhuah chhe ber pawh a veng thei a ni. Khawvel hmun thenkhatah chuan nau neih hmaa enkawlna hmun thenkhatah chuan nau piang 100,000 zinga 2.5 vel chauhvin Rh incompatibility vangin harsatna an nei a ni. Hei hi Sri Lanka-ah pawh ngaihtuahawm tak a ni.

Engtin nge hei hi i hmuh?

A tlangpuiin antenatal clinic-ah chuan i thisen chi leh ``antibodies'' eng pawh enfiah thin a ni. Naupai i nih a, Rh-negative blood type i neih chuan i doctor chuan Rh-positive thisen laka ``antibodies'' a awm leh awm loh a enfiah ang. Chutiang ``antibodies'' te chu i neih loh chuan i immune system chu an siam chhuah loh nan damdawi pek an ni ang.

Test-in heng antibody te hi i nei tih a finfiah chuan naute chu Rh-positive a nih chuan i immune system hian naute thisen sen (red blood cells) a bei thei tihna a ni. Chumi hnuah chuan i doctor chuan kar engemaw zat danah i antibody level a enfiah ang. I antibody level hlauhawm taka a san chuan i naute hian thisen tlakchhamna a nei em tih hriat nan test dang tih belh a ni thei a, nausen pum chhungah thisen pek a ngai mai thei bawk. I naute chu thisen tlakchhamna nasa tak neia piang hlauhawm a nih chuan i doctor chuan naute chu a hmaa nau neih a rel mai thei.

Naute a pian hnuah doctor chuan naute thisen chi hrang hrang a hre thei a. Hei hian naute thisen tlakchhamna hi thisen chi hrang hrang inrem lohna vang a ni em tih hriat nan a pui thei a ni.

Test dang tih te chu:

• Complete Blood Count (CBC): He test hian naute thisen sen (red blood cells) a hniam zia a enfiah thei a ni. Level a hniam poh leh thisen tlakchhamna a na zual thin.
• Peripheral Blood Smear (PBS): Hei hian thisen sample chu microscope hmanga enfiah a ni. Hei hian a tlahniam chhan chu thisen sen (red blood cells) a hun hmaa tihchhiat vang nge ni tih ngaihtuahna a pe thei a ni.
• Bilirubin test: 1.1.Hei hian bilirubin level a teh a ni. Bilirubin hi thisen sen (red blood cells) tihchhiatna atanga lo chhuak a ni. Bilirubin level sang (hyperbilirubinemia) hian thisen sen (red blood cells) a tichhia tih a tilang thei.
• Direct Antiglobulin Test (DAT): He test hian naute thisen sen (red blood cells) chung lamah antibody a awm leh awm loh a entir a. Chumi awmzia chu nu in immune system hian naute cell a bei tihna a ni.

Enkawlnate chu engte nge ni?

Enkawlna chu naupai emaw, nau neih thar emaw a innghat a ni.

Naupai laia enkawl dan

Erythroblastosis Fetalis vei theihna tur antibody i neih chuan i doctor chuan kar tlemte danah i antibody level a enfiah ang. I antibody level a san chuan i naute chu thisen tlakchham a nih leh nih loh hriat nan ultrasound scan dang i neih belh a ngai mai thei. Thisen tlakchhamna a nasat chuan i naute hian thisen pek a ngai mai thei.

Naute pian hnua enkawl dan

Doctor-te chuan nau piang tharte chu ``Erythroblastosis Fetalis'' vei te chu thisen tlakchhamna leh ``hyperbilirubinemia'' (jaundice) te enkawlin an enkawl thin. Enkawlna kawng hrang hrang chu:

• Phototherapy: Hei hian hyperbilirubinemia enkawl nan light a hmang thin. He êng hian bilirubin chu naute taksa atanga awlsam taka chhuak thei thilah a chantir a ni.
• Thisen pek: Nausen pian hnuah thisen sen a mamawh a, thisen sen (red blood cells) a neih tlem theih nan thisen pek a ngai mai thei.
• Erythropoiesis Stimulating Agents (ESA): Hengte hi thisen pek ngai khawpa na lo thisen tlakchhamna enkawlna atana duhthlan tur a ni thei. Naute chu thisen sen hrisel tak siam turin iron supplement nen pek a ngai mai thei.

A nasat chuan naute hian puitu enkawlna a mamawh thei a, chu chu ventilator leh IV fluids te hi a ni.

Hetiang dinhmun hnu hian naute chungah eng nge thleng?

A result chu i naute symptoms nasat danah a innghat. Anemia na tak leh hyperbilirubinemia te hi enkawl loh chuan thihna thlen thei a ni.

Mahse, Erythroblastosis Fetalis vei naute chu uluk taka enkawl an nih chuan an dam khawchhuak thei a ni. Naupai lai leh/ emaw nau neih hnuah pawh an thisen sen (red blood cells) tihpun nan thisen pek an ngai mai thei. Doctor chuan thla engemaw zat chhung chu harsatna a awm loh nan a enfiah a ngai dawn a ni.

Hei hi a veng thei lo em ni?

A theih ngei ang! Erythroblastosis Fetalis hi naupai laiin thisen chi test leh venna damdawi hmanga ven theih a ni hle .Dinhmun. Rh-negative i nih chuan i taksain Rh-positive thisen laka antibody a siam loh nan Rh immune globulin (Rh immune globulin - RhIg emaw RhoGAM®) i ei thei ang. He damdawi hi naupai kar 28-ah, naupai tawp atanga darkar 72 chhungin (nau neih hnuah, nau pai) leh naupai laiin thisen chhuak nasa tak i neih chuan (first trimester-ah pawh) i ei a ngai a ni.

Hei hian i thisen Rh-positive thisen a luh hmaa he damdawi hi i ei phawt chuan a thawk thei a ni. Chuvangin naupai enkawlna hmunah chuan a bik takin an thlir a ni.

I doctor zawh tur thil

Hemi chungchanga zawhna dang i neih chuan i doctor emaw nurse emaw zawh hreh suh. Entirna thenkhat chu hetiang hi a ni:

• Ka thisen hi eng nge ni?
• Ka ngaihtuah tur ``antibodies'' a awm em?
• `(Erythroblastosis Fetalis)` hi ka ngaihtuah tur em ni?
• Monitoring dang emaw, clinic tlawh fo emaw ka mamawh ang em?
• Rh immune globulin (RhIg) ka ei a ngai dawn em ni?
• Engtikah nge appointment ka siam ang emaw, emergency care ka zawn ang?

Nu chu Rh-positive a ni a, naute chu Rh-negative a nih chuan eng nge thleng ang?

Hei hi thisen chi inrem lohna ngaihtuah tur a ni lo tlangpui. Rh-negative nausen hian nu immune system-in a beih theih Rh-antigen a nei lo. Thisen chi hrang hrang inmil lohna hmuh tur awm lo dang a awm loh chuan hei hi harsatna a ni tur a ni lo.

Thil pawimawh tak tak hriat reng tur

I taksa hriselna (immune system) hian i nausen piang lai chu a bei thei tih ngaihdan hi a hlauhawm hle. Mahse chanchin lawmawm tak chu heng thisen inrem lohna hlauhawm tak takte hi a tam lo hle. Tin, doctor-te chuan heng harsatnate hi a thlen loh nan theihtawp an chhuah thin. Thisen chi test hi nau neih hmaa enkawlnaah chuan tih ngei ngei tur a ni. Tin, i naute tana hlauhawm thei thisen chi hrang hrang inmil lohna enfiah leh enkawl hi nau neih hmaa enkawlnaah hian a awm tawh a ni. I doctor chuan i naute leh i naute himna tur kawng tinrengah a awmpui ang che. Chuvangin, a tul lovah hlauthawng suh la, doctor thupek chu uluk takin zawm rawh. Tichuan nang leh i naute chu in hrisel thei ve ve!

` Erythroblastosis Fetalis, Rh incompatibility, naupai harsatna, naute thisen chi, nu thisen chi, thisen tlakchhamna, jaundice, RhoGAM