gynecology and obstetrics
Hemolytic Disease of the Fetus and Neonate
Treatment of Hemolytic Disease of the Fetus and Neonate
Fetal blood transfusions Sometimes delivery at 32 to 35 weeks If fetal blood is Rh negative or if MCA blood flow remains normal, pregnancy can continue to term untreated. If fetal anemia is likely, the fetus can be given intravascular intrauterine blood transfusions by a specialist at an institution equipped to care for high-risk pregnancies. Transfusions occur every 1 to 2 weeks, usually until 32 to 35 weeks. During that time period, delivery may be recommended if there is continuing evidence of severe fetal anemia (based on MCA blood flow). The woman may continue to term delivery if there is no evidence of severe fetal anemia based on MCA blood flow. Corticosteroids should be given before the first transfusion if the pregnancy is>24 weeks, possibly>23 weeks. Neonates with erythroblastosis are immediately evaluated by a pediatrician to determine need for Exchange transfusion . 