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Hemoglobin E (HbE) is an abnormal hemoglobin with a single point mutation in the β chain. At position 26 there is a change in the amino acid , from glutamic acid to lysine (E26K). Hemoglobin E is very common among people of Southeast Asian , Northeast Indian , Sri Lankan and Bangladeshi descent.
Embryonic hemoglobin is a tetramer produced in the blood islands in the embryonic yolk sac during the mesoblastic stage (from 3rd week of pregnancy until 3 months). The protein is commonly referred to as hemoglobin ε. Chromosomal abnormalities can lead to a delay in switching from embryonic hemoglobin. [3]
Anemia is a condition in which blood has a lower-than-normal amount of red blood cells or hemoglobin. [1] Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in pregnancy world-wide, conferring a number of health risks to mother and child. [2]
The normal hemoglobin types are Hemoglobin A (HbA), which makes up 95–98% of total hemoglobin in adults, Hemoglobin A2 (HbA2), which constitutes 2–3% of total hemoglobin in adults, and Hemoglobin F (HbF), which is the predominant hemoglobin in the fetus during pregnancy, and may persist in small amounts in adults. [1]
Hemoglobin F is found in fetal red blood cells, and is involved in transporting oxygen from the mother's bloodstream to organs and tissues in the fetus. It is produced at around 6 weeks of pregnancy [1] and the levels remain high after birth until the baby is roughly 2–4 months old. [2]
Unstable hemoglobin variants are mutations that cause the hemoglobin molecule to precipitate, spontaneously or upon oxidative stress, resulting in hemolytic anemia. Precipitated, denatured hemoglobin can attach to the inner layer of the plasma membrane of the red blood cell (RBC) forming Heinz bodies , leading to premature destruction of the ...
During pregnancy the plasma volume increases by 40-50% and the red blood cell volume increases only by 20–30%. [22] These changes occur mostly in the second trimester and prior to 32 weeks gestation. [24] Due to dilution, the net result is a decrease in hematocrit or hemoglobin, which are measures of red blood cell concentration.
The anti-RhE antibody can be naturally occurring, or arise following immune sensitization after a blood transfusion or pregnancy. The anti-RhE antibody is quite common especially in the Rh genotype CDe/CDe; it usually only causes a mild hemolytic disease, but can cause a severe condition in the newborn.