Hemolytic disease of the newborn. It sounds scary, frightening - especially in combination with the touching word “newborn”. And this is a truly serious pathology that requires urgent medical intervention. According to forecasts, more than 90% of children who received timely treatment subsequently do not have neurological disorders. Therefore, you cannot hesitate; you need to diagnose it in time and take action.
Since, as a rule, TTH manifests itself in the first days of a child’s life, treatment is prescribed immediately, please trust and do not interfere with the actions of doctors!
So, what kind of disease is TTH? This is the destruction of the red blood cells of a newborn baby by the antibodies of his mother. And the reason for it is the incompatibility of maternal and child blood in terms of red blood cell (erythrocyte) antigens, usually the Rh factor and the blood group system, and, sometimes, other blood factors.
What is the reason?
If the mother has Rh negative blood and the child has Rh positive blood, then Rh incompatibility occurs. Because of this, the mother’s immune system can identify the fetus’s red blood cells as potentially dangerous, foreign, and begin to produce antibodies against the Rh factor located on them. Having attached to the child’s red blood cells, antibodies destroy them. Moreover, this process begins during the period of intrauterine development of the fetus and continues after the birth of the child. If the fetus has Rh-negative blood, and the mother has Rh-positive blood, then this situation does not arise.
Diagnostic methods
As a rule, a patient with a headache consults a neurologist. At the first appointment with a doctor, the patient must answer a number of questions - how often does a headache occur, what can it be associated with, what time of day does it occur, where is it localized. Then a life history will be collected - the doctor will find out what diseases were previously diagnosed, whether head injuries have occurred recently, and so on.
Often such a full-fledged survey is enough to make a diagnosis, but in order to prevent mistakes, specialists prescribe an instrumental examination, often a computed tomography of the brain. If there are no morphological pathological changes in the structure of the brain, blood pressure levels are within normal limits, and no other reasons for the occurrence of the condition in question have been identified, then the diagnosis is considered complete.
How not to miss the symptoms of hemolytic disease
While the mother is pregnant, signs of blood incompatibility do not manifest themselves in any way in either the mother or the fetus. And after birth, HDN clinically manifests itself in different ways, depending on what form it takes: anemic, icteric and edematous. There are also cases of a combination of these forms. Let's look at them separately.
1. Anemic form. It is considered the easiest. Its manifestations are pallor of the skin, neurological disorders, for example, too much sleep, lethargy, apathy, poor appetite, and a sluggish sucking reflex. In addition, there are signs of enlargement of the spleen and liver, observed over time.
2. Jaundice form. The most common form. It is diagnosed in almost 90% of cases. With this form, jaundice is the most important symptom. Literally in the first hours of life, the skin and mucous membranes acquire a yellow tint, and enlargement of the liver and spleen is possible. The severity of the jaundice form is determined by the distribution throughout the body and the intensity of jaundice. This is determined visually using the Cramer scale. There are five degrees in total, with the first affecting the face and neck, and with the fifth the whole body. The intensity of jaundice depends on the level of bilirubin, which gives the skin its yellow color. A critical level of this enzyme can affect the neurons of the brain, its structures, and cause a serious and dangerous complication, bilirubin encephalopathy.
3. Edema form (“hydrops fetalis”). This is the most severe form, most often diagnosed in utero. The icteric coloration of the membranes, amniotic fluid, and umbilical cord did not go unnoticed by doctors. From the moment of birth, the child has swelling throughout the body - subcutaneous, abdominal, chest. The condition of the newborn is serious. Children diagnosed with this particular form of the disease require intensive treatment, including blood transfusions.
Immediately after birth, it is important for children, especially those at risk, to determine their blood type . Children who do not have the same blood type or Rh group as their mother should be examined by a doctor several times during the first day of life.
Mom herself may notice jaundice, as well as excessive pallor of the mucous membranes and skin. In this case, you must immediately inform your doctor.
HDN should not be confused with other diseases of newborns:
- hereditary hemolytic or posthemorrhagic anemia;
- non-immune hydrops fetalis;
- various infections, etc.
Only a doctor can make an accurate diagnosis; do not try to make a diagnosis yourself or downplay its importance.
Tension headache: causes, symptoms, diagnosis and treatment
Most people know about it firsthand. Severe and not very, rare and frequent - headache.
Today we are talking about one of its varieties - tension headaches - with Natalya Vladimirovna Umerenkova, a leading neurologist at Clinic Expert Kursk LLC.
Natalya Vladimirovna, please tell me what a tension headache is and how does it manifest itself?
This is one of the types of headaches. According to statistics, it occurs at least once in a lifetime in 80% of all people.
Tension headaches are usually bilateral, of weak or moderate intensity, pressing, squeezing in nature: figuratively, a person can say that the head seems to be covered by a “helmet” or “hoop.” The duration of pain is 30 minutes or more. Depending on how many days a headache occurs during the month, it is divided into episodic and chronic.
Some patients also experience muscle tension in the head and/or neck.
This pain usually does not significantly affect daily activity and performance and does not intensify with usual physical activity.
How to distinguish tension headaches from other types of headaches - in particular, those observed with migraines and VSD?
It can be distinguished, first of all, by the characteristics of the pain itself.
For example, with a migraine, the pain is often one-sided, more intense, bursting or throbbing, can spread to the eye area, is sometimes accompanied by nausea and vomiting, and significantly limits a person’s daily life.
Headache with VSD does not have any typical distinctive features. What is important: headache here is not the main and far from the only symptom. Some symptoms inherent in this disease: episodes of dizziness, palpitations, a feeling of “lightheadedness,” sweating of the palms, trembling of the hands, tingling in the chest, a feeling of incomplete inspiration.
How is tension headache diagnosed?
The clinical manifestations of the disease are of primary importance. We clarify in detail the patient’s pain characteristics, other complaints, and conduct a neurological examination.
We often ask our patients to keep a “pain diary” to make a definitive diagnosis. These are regular recordings of episodes of pain with its description, i.e. about the nature (for example, squeezing, squeezing), intensity, location, factors provoking it, as well as what helps to alleviate or eliminate it.
If the picture of the disease is not entirely typical, additional research methods may be prescribed - in particular, magnetic resonance or computed tomography of the head and cervical spine, studies of the great vessels of the neck, and neurophysiological studies.
How is tension headache treated?
First of all, I would like to say the following points:
- It is necessary to change the attitude towards the disease. The patient needs to know that this is a benign headache. Why is it important? Some of our patients may, on their own initiative, undergo various examinations for a long time in an attempt to find the cause of their complaints. However, with this disease, instrumental diagnostic methods “do not show anything.” Because of this, the patient's anxiety may increase, which, in turn, may contribute to the worsening of the headache. Therefore, to avoid this, I recommend that if you experience headaches, see a doctor who will advise you on the additional research you need;
— learn self-relaxation techniques. Automotive training, meditation, yoga can help with this;
- massage, physiotherapy, manual therapy, acupuncture may be useful.
As for medications, they are selected by the doctor depending on the course of the disease and the severity of symptoms. For mild pain, painkillers may not be prescribed.
If the pain intensifies, then drugs of different groups are used:
- for episodic tension headaches, these are, first of all, non-steroidal anti-inflammatory drugs;
— in the chronic course of the disease, antidepressants are used. You shouldn’t be confused by the name: research has shown that they are effective not only for depression as such, but also for certain types of pain;
- if there is tension in the muscles of the head and neck, certain types of muscle relaxants are used to relax the muscles.
Natalya Vladimirovna, what can you recommend to prevent tension headaches?
It is necessary to observe a work and rest schedule. A rational posture when performing work is very important to avoid overstraining the muscles of the neck and shoulder girdle. When working sedentarily, regular breaks are required throughout the day, approximately every 30 minutes. Physical therapy, sports, and swimming are useful. If possible, you should avoid stressful situations, and also try to react to them more calmly.
Is tension headache coded in the International Classification of Diseases (ICD-10)? If so, how?
Yes, it is present in ICD-10, designated G44.2 with subsections.
Other related articles:
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It's off scale! Looking for reasons for high blood pressure
Is there such a diagnosis as osteochondrosis?
For reference:
Umerenkova Natalya Vladimirovna
In 2004 she graduated from Kursk State Medical University.
In 2004-2005, she completed an internship in neurology at the above-mentioned university.
Since 2015, he has been working at Clinic Expert Kursk LLC, and is a leading specialist in the neurology department.
Treatment of chronic tension headache
If a tension headache occurs in a chronic form, then it is forbidden to take classical drugs with an analgesic effect! Not only will they not relieve pain, but they will also complicate the process of full treatment. Doctors prescribe antidepressants, which must be taken for six months according to a specially developed individual regimen. It is also possible to prescribe other medications from the group of antidepressants; the course of therapy is at least 60 days.
This treatment tactic involves not only getting rid of pain, but also eliminating the cause of tension headaches - for example, antidepressants solve the problem of dysfunction of the autonomic nervous system. Physiotherapeutic procedures (the same as in the case of therapy for episodic pathology) will also have an additional therapeutic effect.
Tension headaches require a professional approach to treatment. If symptoms of this disease appear, it is advisable to contact specialists at CELT - all necessary diagnostic measures will be carried out and treatment will be prescribed.
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