Fetal erythroblastosis

Fetal erythroblastosis

Fetal erythroblastosis is a haemolytic anemia that occurs in the fetus or newborn. It is caused by a blood level incompatibility between mother and fetus (especially Rh factor) that occurs through the transplacental transmission of maternal antibodies.

What are the causes?

Classical fetal erythroblastosis results from Rh0 (D) incompatibility. This develops when a Rh-negative woman intersects with a Rh-positive man and the product of their conception, that is, the fetus, is Rh-positive.

Not only is Rh incompatibility the basis of fetal erythroblastosis, there are other types of fetal incompatibilities, but they are very rare. Some of these include mismatch between blood groups (AOB system) between mother and child.

It seems that erythroblastosis was rarely encountered in a woman's first pregnancy and that there is a greater predisposition for subsequent pregnancies. Then Rh sensitization may occur.

Thus, the mother's immune system reads the Rh cells of the fetus as foreign. Thus, he begins to create antibodies that cross the placenta and are directed against them. The effect is the destruction of red blood cells, which can cause severe fetal disease. This disease in the fetus is detectable at birth and is called hemolytic disease.

What are the symptoms?

During pregnancy, fetal erythroblastosis can make itself felt by:

  • liver, spleen or enlarged heart in the fetus (by ultrasound);

  • accumulation of amniotic fluid in the abdomen of the fetus;

  • amniotic fluid colored in yellow

After birth, the baby may have the following symptoms:

  • skin coloration specific to anemia (pallor);

  • yellow coloration of the skin following jaundice caused by increased bilirubin levels;

  • enlarged liver or spleen;

  • breathing problems etc.

How is the diagnosis made?

Before pregnancy

Diagnosis of this incompatibility can be made again during prenatal testing. Detecting the disease may require screening for maternal antigens or testing for Rh-positive antibodies in the mother's blood.

During pregnancy

Ultrasound is another method that can help doctors establish the diagnosis in the fetus during pregnancy. With her help, they evaluate blood flow and other problems that occur in the blood vessels, tissues and organs.

In some cases, where there are very high suspicions, doctors may advise the pregnant woman to do amniocentesis. It is a method of diagnosing the most serious chromosomal and genetic abnormalities and certain diseases at birth. But it is an invasive method, which involves many risks to the fetus.

It is also possible to use tissue samples from the umbilical cord of the fetus to help doctors check:

  • antibodies;

  • anemia;

  • bilirubin etc.

After birth

After the baby is born, doctors can do additional tests to diagnose erythroblastosis:

  • umbilical cord blood analysis;

  • Rh factor;

  • testing the number of red blood cells, etc.

How is it treated?

Fetal erythroblastosis can be treated both during pregnancy and after birth, depending on when it is detected.

During gestation, this mainly includes blood transfusions (intrauterine) with red cells in the blood of the fetus body. It has the role of replacing the affected blood. It is a delicate procedure and with many risks, because there is a danger that the fetus will move during this procedure.

After birth, the baby is taken under medical supervision by the pediatrician and a treatment scheme is established based on:

  • gestational age (if he was born term or premature);

  • health status;

  • medical history;

  • the stage of evolution of the disease;

  • tolerance to certain drugs.

Once these parameters are established, doctors also use blood transfusions to treat severe anemia, but also fluids to reduce hypertension. Transfusions could be repeated until bilirubin levels decrease.

Tags Compatibility rh parents Newborn jaundice Baby disorders