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Erythroblastosis Fetalis

Cecilia M. Kipnis, MD, FAAFP and Chelsea L. Hayes, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Hemolytic anemia of the fetus or newborn is caused by transplacental transmission of maternal IgG antibodies against fetal red blood cells.

  • When severe, fetal anemia may result in ext...

DIAGNOSIS

PHYSICAL EXAM

  • Antenatal (the fetus)

    • Hepatomegaly

    • Splenomegaly

    • Hydrops (two or more of the following ultrasonography [US] findings: ascites, pericardial effusion, pleural effusion, skin edema, po...

TREATMENT

GENERAL MEASURES

  • Intrauterine transfusion is indicated when the fetal hematocrit is ≤30 OR is two standard deviations below the mean value for gestational age.

  • The intravascular approach for t...

ONGOING CARE

PROGNOSIS

  • 50% of affected infants have mild disease and require no treatment (or treatment of anemia and jaundice only after delivery).

  • 30% have moderate disease with anemia and hepatomegal...

REFERENCES

1
Aitken SL, Tichy EM. Rh(O)D immune globulin products for prevention of alloimmunization during pregnancy. Am J Health Syst Pharm.  2015;72(4):267–276. {L-End} [View Abstract on OvidM...

ADDITIONAL READING

  • Bowman J. Thirty-five years of Rh prophylaxis. Transfusion.  2003;43(12):1661–1666.

  • Cardo L, García BP, Alvarez FV. Non-invasive fetal RHD genotyping in the first trimester of p...

SEE ALSO

  • Anemia, Autoimmune Hemolytic

  • Algorithm: Jaundice, Newborn

CODES

ICD10

  • P55.9 Hemolytic disease of newborn, unspecified

  • P55.0 Rh isoimmunization of newborn

  • P55.1 ABO isoimmunization of newborn

  • P55.8 Other hemolytic diseases of newborn

ICD9

  • 773.2 Hemolytic disease of...

CLINICAL PEARLS

  • Alloimmunization is the most common cause of HDFN; Rh antigen alloimmunization is most frequently acquired via fetomaternal hemorrhage and inadequate dosing or lack of treatment with R...

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