Erythroblastosis fetalis, also known as hemolytic disease of the newborn is a condition that develops in a fetus when antibodies produced by the mother attack the fetus's red blood cells.

Symptoms

Symptoms include yellowish skin and eye discoloration within 24 hours after birth, a severe form of Hydrops Fetalis (pallor, an enlarged liver and/or spleen, generalized swelling, respiratory distress, petechiae, purpura, death in uterus or shortly after birth). The baby can die in some cases.

Cause

Erythroblastosis fetalis is caused by the passage of maternal antibodies via the placenta when there is a difference in blood type between the pregnant mother and the fetus. Problems include Rh Incompatibility, ABO incompatibility or other blood group incompatibilities such as c, E, Kell(K).

How The Diagnosis is made

The diagnosis is based on history and lab findings:

1. Peripheral blood morphology shows increased reticulocyte, nucleated red blood cells
2. Positive Coombs test

Treatment

Before birth, options for treatment include intrauterine transfusion or early induction of labor when pulmonary maturity attained, fetal distress is present, or 35- 37 weeks of gestation have passed.

After birth, treatment depends on the severity of the condition, but could include temperature stabilization and monitoring, phototherapy, transfusion with compatible packed red blood, exchange transfusion, sodium bicarbonate for correction of acidosis and/or assisted ventilation.

Complications

Complications could include kernicterus, hepatosplenomegaly, inspissated (thickened or dried) bile syndrome and/or greenish staining of the teeth.

Similar Conditions

Similar conditions include acquired hemolytic anemia, congenital toxoplasma and syphilis infection, congenital obstruction of bile duct and cytomegalovirus infection.