ERYTHROCYTE MORPHOLOGY IN NEONATAL RHESUS FACTOR AND ABO ISOIMMUNIZATION

Objective: to conduct an atomic force microscopy (AFM) study of the red blood cell nanostructure in neonatal infants with ABO and rhesus (Rh) isoimmunization. Subjects and methods. The investigation included 27 neonates, including 13 infants with Rh sensitization and 14 with ABO isoimmunization. The course of pregnancy complicated by Rh sensitization was characterized by the emergence of the blood titers of Rh D antibodies and immunoglobulin G (IgG) subclasses: IgG1, IgG2, and IgG3. IgG production increased at 34 weeks' gestation when all the subclasses were detectable in different titers. There was either Rh or ABO incompatibility between the newborns and their mothers. Differential diagnosis of isoimmunization was made in the pair of an O (I) Rh-negative mother and an A (II) Rh-positive baby. Complete blood count and blood biochemical indicators were estimated; Rh D and IgG antibody titers were determined; red blood cells from 11 neonatal infants were examined using an AFM. The investigation was performed with residual umbilical cord blood and central venous blood during neonatal treatment. Results. Combination therapy for neonatal Rh or ABO isoimmunization terminates a cascade of immunological responses and erythrocyte hemolysis, lowers bilirubin levels, but fails to influence the morphological composition and macrostructure of red blood cell membranes. The consequences of the perinatal effects on the red blood cell membrane persist for a certain time and are outside the early neonatal period.

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