Navigating Autoimmune Hemolytic Anemia in Pregnancy

Autoimmune hemolytic anemia is when your immune system mistakenly attacks and destroys your red blood cells, leading to anemia. But don’t worry, it can be diagnosed and treated, so it’s important to learn more about it.

The causes of this condition fall into two categories: primary and secondary. Primary causes are unknown and account for half of the cases. The other half are due to secondary factors and conditions.

There are two types of secondary autoimmune hemolytic anemia: warm-type and cold-type.

Warm-type can result from conditions like lupus, scleroderma, Crohn’s colitis, rheumatoid arthritis, and some cancers like chronic lymphocytic leukemia and lymphoma. Infections and other cancers can also sometimes cause it.

Cold-type is often linked to the same cancers and infections such as viral pneumonia, mononucleosis, and mycoplasma.

The symptoms of autoimmune hemolytic anemia include pale skin, fatigue, dizziness, heart palpitations, shortness of breath, and in severe cases, loss of consciousness or death. The breakdown of red blood cells can also lead to jaundice, itchy skin, and dark urine.

Pregnant women can also experience anemia. During pregnancy, the body produces more plasma, diluting red blood cells and leading to physiological anemia. This isn’t caused by the destruction of red blood cells but by their decreased concentration. Iron supplements can help manage this by increasing red blood cell production.

Up until 2015, there wasn’t much detailed information on autoimmune hemolytic anemia in pregnancy. However, it’s known that it usually occurs in late pregnancy and responds well to steroid treatment, with or without blood transfusions, often without harming the baby. Sometimes, the condition resolves on its own after pregnancy.

Autoimmune hemolytic anemia during pregnancy can be risky for both mother and baby, especially if the antibodies are immunoglobulin G, which can cross the placenta. Most treatments work well to reduce the autoimmune reaction, but there are cases where they don’t. For instance, one woman with severe anemia had her baby delivered early and was treated with steroids and blood transfusions, while her baby received transfusions and phototherapy. Both recovered fully without complications.

Another study found that two women diagnosed with warm-type autoimmune hemolytic anemia in the late third trimester responded well to steroid treatment and delivered healthy babies without any signs of hemolysis.

Overall, autoimmune hemolytic anemia is treatable, and it’s important to recognize the symptoms and understand how it can affect pregnancy. More research is needed to fully understand the condition, but the main goal of treatment is to stop the breakdown of red blood cells and correct the anemia.