P57.0: Kernicterus due to isoimmunization

An excessive level of bilirubin has damaged parts of the child’s brain.

Blood is made up of a liquid part and different blood cells, among other things. The blood cells include the red blood cells, the white blood cells and the platelets. The red blood cells carry oxygen from the lungs throughout the body. When red blood cells get broken down, bilirubin results. Bilirubin is yellow. In the liver, bilirubin enters the bile from the blood. Some of the bile is then excreted with the stool.

Red blood cells in the child were destroyed by the mother's antibodies. The mother might produce antibodies like these if red blood cells get into her blood. Red blood cells from the child can get into the mother's blood during pregnancy or at birth. This may also involve an earlier pregnancy or birth. The antibodies from the mother can get into the unborn child's blood via the placenta. The placenta forms in the mother’s womb during pregnancy. The placenta consists of cells from the mother and cells from the unborn child. The umbilical cord connects the child to the placenta.

When these antibodies from the mother get into the child's body they can destroy red blood cells there. Red blood cells can be destroyed before and after the birth. If a lot of the child's red blood cells are destroyed, a great deal of bilirubin might be present in the blood. Before the birth, bilirubin can be transported out of the child's blood via the placenta. After the birth, the bilirubin might not be adequately excreted via the bile and the stool. As a result, the bilirubin can accumulate in various body tissues. Neo-natal jaundice then develops.

When a baby has jaundice, the whites of its eyes and its skin can be yellow. A very high level of bilirubin in the blood has also caused damage in the brain. There can be different indications of brain damage. There may first be a sucking weakness and severe lethargy. The child may also suffer seizures and breathing interruptions. Paralyses and mobility disorders are also possible. Its hearing may also be impaired. The brain damage may also prevent the proper development of certain mental capabilities.