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Hemolytic disease of the newborn


HDN; Erythroblastosis fetalis Last reviewed: November 14, 2011. Hemolytic disease of the newborn (HDN) is a blood disorder in a fetus or newborn infant. In some infants, it can be life threatening. This article provides a general overview. For more detailed information see the specific disorder:

ABO incompatibility Rh incompatibility

Causes, incidence, and risk factors


HDN may develop when a mother and her unborn baby have different blood types (called "incompatibility"). The mother produces substances called antibodies that attack the developing baby's red blood cells. The most common form of HDN is ABO incompatibility, which is usually not very severe. Other, less common types may cause more severe problems. The least common form is Rh incompatibility, which can almost always be prevented. When this form does occur, it can cause very severe anemia in the baby.

Symptoms
HDN can destroy the newborn baby's blood cells very quickly, which can cause symptoms such as:

Edema (swelling under the surface of the skin) Newborn jaundice

Signs and tests


Signs of HDN include:

Anemia or low blood count Enlarged liver or spleen Hydrops (fluid throughout the body's tissues, including in the spaces containing the lungs, heart, and abdominal organs)--which can lead to heart failure from too much fluid

Which tests are done depends on the type of blood group incompatibility and the severity of symptoms, but may include:

Complete blood count and immature red blood cell (reticulocyte) count Bilirubin level Blood typing

Treatment
After birth, a transfusion may need to be performed. Infants with mild HDN may be treated with:

Drugs used to treat allergic reactions (antihistamines) Drugs used to treat swelling and allergies (steroids) Feeding and fluids (hydration) Fluids given through a vein (intravenously) Light therapy using bilirubin lights Medicines to raise blood pressure if it drops too low

Expectations (prognosis)
The severity of this condition can vary. Some babies have no symptoms. In other cases, problems such as hydrops can cause the baby to die before, or shortly after birth. Severe HDN may be treated before birth by intrauterine transfusion.

Prevention
The most severe form of this disease, which is caused by Rh incompatibility, can be prevented if the mother takes a medicine called RhoGAM at certain times during and after her pregnancy. If you have had a baby with this disease, talk with your doctor if you plan to have another baby.

References
1. Gruslin AM, Moore TR. Erythroblastosis fetalis. In: Martin R, Fanaroff A, Walsh M, eds. Neonatal-Perinatal Medicine. 9th ed. Philadelphia, Pa: Mosby Elsevier; 2011. 2. Cohen DW. Hemolytic disease of the newborn: RBC alloantibodies in pregnancy and associated serologic issues. UpToDate, Waltham, MA. Nov 2009. Review Date: 11/14/2011. Reviewed by: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review

Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Intrauterine transfusion

Erythroblastosis fetalis is a condition manifested by anemia that develops in an unborn infant when maternal antibodies, usually caused by Rh incompatibility between the mother's blood type and that of the fetus, attack the red blood cells of the fetus. An intrauterine transfusion of blood may be indicated. Review Date: 11/14/2011. Reviewed by: Kimberly G. Lee, MD, MSc, IBCLC, Associate Professor of Pediatrics, Division of Neonatology, Medical University of South Carolina, Charleston, SC. Review Provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Copyright 2012, A.D.A.M., Inc. PubMed Health. A service of the National Library of Medicine, National Institutes of Health

Antibodies

Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens. Review Date: 8/4/2011. Reviewed by: Chad Haldeman-Englert, MD, Wake Forest University School of Medicine, Department of Pediatrics, Section on Medical Genetics, Winston-Salem, NC. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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Copyright 2012, A.D.A.M., Inc. PubMed Health. A service of the National Library of Medicine, National Institutes of Health

Erythroblastosis fetalis - All Information


Overview Symptom Treatment Prevention All Information

Alternative Names

Hemolytic disease of the newborn


Definition of Erythroblastosis fetalis:

Erythroblastosis fetalis is a potentially life-threatening blood disorder in a fetus or newborn infant. This article provides a general overview. For more detailed information see the specific disorder:

ABO incompatibility Rh incompatibility

Causes, incidence, and risk factors:

Erythroblastosis fetalis develops in an unborn infant when the mother and baby have different blood types. The mother produces substances called antibodies that attack the developing baby's red blood cells. The most common form of erythroblastosis fetalis is ABO incompatibility, which can vary in severity. The less common form is called Rh incompatibility, which can cause very severe anemia in the baby.

Symptoms:

Symptoms in a newborn baby may include:


Anemia Edema (swelling under the surface of the skin) Enlarged liver or spleen Hydrops (fluid throughout the body's tissues, including in the spaces containing the lungs, heart, and abdominal organs) Newborn jaundice

Signs and tests:

Specific tests depend on the type of erythroblastosis, but may include:


Complete blood count Bilirubin level Blood typing

Treatment:

After birth, depending on the severity, a transfusion usually needs to be performed. For specific treatment information, see:

ABO incompatibility Rh incompatibility

Expectations (prognosis):

The severity of this condition can vary widely. In some instances, the baby has no symptoms of the disease. In other cases, it can lead to death of the baby before or shortly after birth. It can be treated before birth by intrauterine transfusion.
Complications:

Complications depend on the specific type of erythroblastosis fetalis.


Prevention:

The most severe form of this disease, Rh incompatibility, can be prevented if the mother takes a medicine called RhoGAM at certain times during and after pregnancy. If you have had a baby with this disease, be sure to talk with your doctor if you plan on having another baby.

Read more: http://www.umm.edu/ency/article/001298all.htm#ixzz1nbZu9KCK

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