gynecology and obstetrics
Hemolytic Disease of the Fetus and Neonate
Key Points
Erythroblastosis fetalis is hemolytic anemia in the fetus caused by transplacental transmission of maternal antibodies to fetal red blood cells, usually due to incompatibility between maternal and fetal blood groups, often Rho(D) antigens. Screen all pregnant women for blood type, Rh type, anti-Rho(D), and other antibodies that can cause erythroblastosis fetalis. Give women at risk of sensitization Rho(D) immune globulin at 28 weeks gestation, within 72 hours of pregnancy termination, after any episode of vaginal bleeding during pregnancy, and after amniocentesis or chorionic villus sampling. If women are at risk, periodically measure antibody levels and, if needed, middle cerebral artery blood flow. Treat erythroblastosis fetalis with intrauterine fetal blood transfusions as needed and, if severe fetal anemia is detected, delivery at 32 to 35 weeks, depending on the clinical situation. 