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erythroblastosis fetalis
Hemolytic anemia in the fetus resulting form maternal antibodies against fetal red cell antigens
Etiology:
1) maternal IgG elicited by maternal-fetal hemorrhage
a) 70% of women in 3rd trimester
b) ABO incompatibility
c) Rh incompatibility
2) blood transfusion
Pathology:
- maternal IgG crosses placenta, binds to & lyses fetal erythrocytes
Clinical manifestations:
- jaundice
- hepatomegaly, splenomegaly
- edema
Genetics:
1) occurs in antigen - (Rh-) most notorious) mothers
2) occurs in antigen + (Rh+) fetus
Laboratory:
1) blood typing; blood typing on Mom should be available
2) positive direct antiglobulin (Coomb's) test on infant's erythrocytes
3) antibodies in maternal serum reactive with fetal red cell antigens
4) complete blood count (CBC) in newborn may show anemia
5) serum bilirubin: hyperbilirubinemia
6) see ARUP consult [5]
Management:
- intrauterine transfusion
- blood transfusion after birth
Related
blood group Rh(D) polypeptide; rhesus D antigen; RHXIII; Rh polypeptide 2; RhPII; CD240D (RHD)
Rh isoimmunization (Rh disease)
General
hemolytic disease of the newborn
References
- DeGowin & DeGowin's Diagnostic Examination, 6th edition,
RL DeGowin (ed), McGraw Hill, NY 1994, pg 883-84
- PubMed Health: Erythroblastosis fetalis
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002275/
- MedlinePlus: Erythroblastosis fetalis
http://www.nlm.nih.gov/medlineplus/ency/article/001298.htm
- Wikipedia: Hemolytic disease of the newborn
http://en.wikipedia.org/wiki/Hemolytic_disease_of_the_newborn
- ARUP Consult: Hemolytic Disease of the Fetus and Newborn
https://arupconsult.com/content/hemolytic-disease-newborn