Hemolytic disease of the newborn

Hydrops fetalis in severe disease. Anemia and jaundice with pallor, tachycardia, edema and hepatosplenomegaly in moderate severity and mild disease shows mild anemia with reticulocytosis.

Due to red cell alloimmunization in which IgG antibodies passage from the maternal circulation across the placenta into the circulation of the fetus where they react with fetal red cells and lead to their destruction.

The fetal red cells of a Rh D-positive fetus can cross into the maternal circulation (Rh D-negative) at delivery or the third semester causing the mother to be sensitized to form anti-D. Anti-D can cross the placenta to destroy the fetal red cells of the next pregnancy if the fetus is Rh-D positive again.

Positive direct antiglobulin test and raised serum bilirubin.

Anti-D IgG is to be given to Rh D-negative women during gestation. Exchange transfusion in severe cases.