Fetal Hemolytic Disease

Antenatal Care

With Veronica Gillispie, MD, FACOG

Etiology of Fetal Hemolytic Disease

Rh negative
mother

High-yield

1st pregnancy
with Rh
positive baby Maternal antibodies
Manifestation of Fetal Hemolytic Disease

This is the second or later pregnancy with a Rh positive baby.

Rh negative
mother

High-yield

Rh positive baby Hydrops fetalis,

under attack hypoxia, death
Maternal antibodies
Prevention of Fetal Hemolytic Disease

Anti-D

Anti-D binds Rh negative

circulation to avoid High-yield

sensitization and Rh negative
mother
development of immune
response/formation of
antibodies vs. Rh negative
Fetal Hemolytic Disease

A 19-year-old female with an incomplete abortion presents to the

emergency room. On physical exam, vitals signs are stable.
On pelvic exam, products of conception are seen at the cervical os.
Her initial laboratory evaluation shows a hemoglobin of 13.
Her blood type is O negative.

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Fetal Hemolytic Disease

In addition to addressing her abortion, what interventions are necessary?

A. Blood transfusion for anemia

B. Rubella immunization

C. Anti-D immune globulin

D. Prophylactic antibiotics

PublicDomainPictures, CC0 PD
Fetal Hemolytic Disease

In addition to addressing her abortion, what interventions are necessary?

A. Blood transfusion for anemia

B. Rubella immunization

C. Anti-D immune globulin

D. Prophylactic antibiotics

PublicDomainPictures, CC0 PD
List of References

• Prevention of Rh D Alloimmunization. ACOG Practice Bulletin, No. 4, May 1999. American

College of Obstetricians and Gynecologists.