title: [Rhesus immunization from a neonatological viewpoint. What is today's crucial aspect?].
abstract: The ultimate goal in the treatment of neonatal Rh-disease is prevention of hyperbilirubinemia and bilirubin encephalopathy syndrome. Therapeutic approaches as exchange transfusion, phototherapy, reduction of enterohepatic circulation and enzyme induction are discussed on the basis of bilirubin metabolism. The impact of endogenous and exogenous factors upon bilirubin-albumin binding is emphasized in more detail. Two main theories for the pathogenesis of bilirubin encephalopathy syndrome are currently under discussion: the cytotoxicity of the free, unbound bilirubin fraction or the transient opening of the blood brain barrier secondary to asphyxia, acidosis and hyperosmolarity.
mesh_terms: D000138:Acidosis / Q000139:chemically induced; D000418:Albumins / Q000627:therapeutic use; D001237:Asphyxia / Q000139:chemically induced; D001663:Bilirubin / Q000378:metabolism / Q000506:poisoning; D001812:Blood-Brain Barrier / Q000187:drug effects; D005078:Exchange Transfusion, Whole Blood; D006801:Humans; D006932:Hyperbilirubinemia / Q000517:prevention & control*; D007114:Immunization; D007231:Infant, Newborn; D009994:Osmolar Concentration; D010789:Phototherapy; D012204:Rh-Hr Blood-Group System / Q000276:immunology
chemical_list: D000418:Albumins; D012204:Rh-Hr Blood-Group System; D001663:Bilirubin
vernacular_title: Die Rhesus-Immunisierung aus neonatologischer Sicht. Wo liegt der Schwerpunkt der Probleme heute?