Pregnancy complicated by red blood cell alloimmunization.
Alloimmunization can occur when fetal cells bearing a foreign antigen to the mother enters the maternal circulation.
As little as 0.1 mL RhD positive blood is enough to cause sensitization in a Rh negative woman.
The risk of fetomaternal hemorrhage is low in the first two trimesters, but increases in the third trimester, and at the time of delivery 50% women have sufficient fetomaternal hemorrhage to be at risk for sensitization.
Fetomaternal hemorrhage and maternal sensitization can be increased by previous abortions, ectopic pregnancies, and invasive procedures including amniocentesis and chorionic villus sampling.
Alloimmunization can occur only if the mother is negative and the fetus is positive for the Rh antigen.
Fetal Rh hemolytic disease anemia may lead to fetal death as early as 17 weeks gestation.
Survival rates exceed 90% if anemia diagnosed and treated with intrauterine blood transfusions.
Anemia severity identified by mother’s obstetrical history and serum antibody levels.
Administration of IgIV in addition to phototherapy results in reduced hemolysis and the need for exchange transfusion.
Symptoms and signs in the newborn:
Anemia that creates the newborn’s pallor.
Jaundice or yellow discoloration of the newborn’s skin, sclera or mucous membrane.
This may be evident right after birth or after 24–48 hours after birth.
This is caused by bilirubin.
Enlargement of the newborn’s liver and spleen.
The newborn may have severe edema of the entire body.
Dyspnea or difficulty breathing.