erythroblastosis fetalis:A neonatal disease caused by blood type incompatibility between the mother and her developing fetus, specifically Rh incompatibility.
SYN: SEE: erythroblastosis fetalis
SEE: Rh blood group
After the introduction into clinical use of Rh immunoprophylaxis, the incidence of hemolytic disease of the newborn fell dramatically in developed nations. It is currently estimated to occur in less than 1 of 1000 pregnancies. The disease is more common in developing nations, e.g., in India and Southeast Asia.
The disease is produced in the developing fetus when maternal antibodies do not match fetal blood groups. Incompatibilities in the Rh antigen system and in some rarer blood antigens can cross the placenta, and cause widespread destruction of fetal red blood cells. Incompatibilities in the ABO blood types are common, but do not cause as severe disease in the fetus or newborn.
In cases of Rh incompatibility, the condition can be controlled during pregnancy by following the anti-Rh titer of the mother's blood and the bilirubin level of the fetus by amniocentesis. These indices show whether the pregnancy should be allowed to go to full term and if intrauterine transfusion is indicated or if labor should be induced earlier. Delivery should be as free of trauma as possible and the placenta should not be manually removed. The infant with hemolytic disease should be immediately seen by a physician who is capable of and has the facilities and blood supplies available for exchange transfusion. The use of Rh (D) immune globulin after abortion, at 28 weeks' gestation, and within 72 hr of delivery has been beneficial.
What Causes Erythroblastosis Fetalis?
There are two main causes of erythroblastosis fetalis: Rh incompatibility and ABO incompatibility. Both are associated with blood type. There are four blood types: A, B, AB, and O. And blood can be either Rh positive or Rh negative. If a person is type A and is Rh positive, they have A antigens and the Rh factor antigens on the red blood cell membrane surface. If a person has AB negative blood, they have both A and B antigens without the Rh factor antigen.
Rh incompatibility occurs when an Rh-negative mother is impregnated by an Rh-positive father. The result can be an Rh-positive baby. In such a case, the baby’s Rh antigens will be perceived as foreign invaders, the way viruses or bacteria are perceived. The mother’s blood cells attack the baby’s as a protective mechanism that can end up harming the child.
If the mother is pregnant with her first baby, Rh incompatibility is not as much of a concern. However, when the Rh-positive child is born, the mother’s body creates antibodies against the Rh factor, which will attack the blood cells if she becomes pregnant with another Rh-positive baby.
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