Hemolytic disease of the newborn

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Summary of Hemolytic disease of the newborn

Hemolytic disease of the newborn is an alloimmune condition that develops in a fetus when antibodies produced by the mother pass through the placenta. Among these antibodies are some which attack the red blood cells in the fetus' circulation, which are broken down and destroyed (hemolysis). The fetus can develop reticulocytosis and anemia. This fetal disease ranges from mild to very severe. Fetal death from heart failure (hydrops fetalis) can occur. Hemolytic disease of the newborn is commonly classified as ABO or Rh subtypes.

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Hemolytic disease of the newborn

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Hemolytic disease of the newborn

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A 32-year old woman, gravida 2, para 1, at 39 weeks’ gestation comes to the emergency department with contractions. She says that she did not have any prenatal care because she does not have health insurance. Upon delivery, the infant appears jaundiced and has marked hepatosplenomegaly. Serum hemoglobin is 11.6 g/dL and serum bilirubin is 8 mg/dL. Direct and indirect Coombs tests are both positive. The mother has never had a blood transfusion. Her previous child was born healthy with no complications. Which of the following is most consistent with the presentation of this disease?

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