Erythroblastosis fetalis presentation explained bestt

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2. Erythroblastosis fetalis
Also known as Hemolytic Disease of the Newborn ,
is a blood disorder in the fetus or newborn caused
by the incompatibility between the blood types of the
mother and fetus, usually involving the Rh factor
DEFINITION

3. Most commonly occurs when an Rh-negative
mother carries an Rh-positive fetus
Less common, occurs when there is a difference
in ABO blood types between the mother and
fetus (e.g., mother is type O, and fetus is A, B, or
AB).
ETIOLOGY
Rh incompatibility:Rh incompatibility:
ABO incompatibility:

6. 1.An Rh-negative mother is exposed to Rh-positive
fetal red blood cells, her immune system forms
antibodies (anti-D).
2.During subsequent pregnancies, these antibodies
can cross the placenta, attacking fetal red Blood
Cells
PATHOPHYSIOLOGY
Mother's immune response:

7. Destruction of fetal RBCs leads to anemia, jaundice, and
other complications.
Hemolysis
1.Anemia,
2.jaundice,
3. heart failure.
4.edema
EFFECT ON FOETUS

9. 1.Fetal anemia
2. Enlarged liver and spleen
3.Hydrops fetalis
CLINICAL FEATURES
In the Foetus:

10. 1.Jaundice (within 24 hours of
birth)
2.Pallor and lethargy
3.Enlarged liver/spleen

IN THE NEWBORN

11. ORAL MANIFESTATION
1.Delayed eruption of teeth
2.Enamel hypoplasia due to intrauterine
disturbances
3.Bilirubin staining of the teeth (discoloration)
4.Potential gum issues due to anemia

12. LAB FINDINGS

13. 1.Anemia: The newborn often presents with
severe anemia due to the destruction of red blood
cells (hemolysis).
2.Elevated Reticulocyte Count: An increased
reticulocyte count indicates the bone marrow's
response to ane
mia.
1.Complete Blood Count (CBC):

14. 1.Immature Erythrocytes: The presence of erythroblasts
(nucleated red blood cells) in the blood is indicative of a
compensatory response to hemolysis.
2.Spherocytes: These may be seen in cases of Rh
incompatibility, indicating membrane loss due to hemolysis.
2.Peripheral Blood Smear:

15. 1.ABO and Rh Typing: Blood group typing of both
mother and newborn is essential.
2.Direct Coombs Test: A positive direct Coombs test
indicates the presence of maternal antibodies
attached to fetal red blood
3. Blood Type and Direct
Coombs Test:

16. 1.Hyperbilirubinemia: Elevated indirect (unconjugated
bilirubin levels are common due to the breakdown of re
blood cells, leading to jaundice.
4. Bilirubin Levels:
Hypoalbuminemia: This may be present in cases of
severe hemolysis.
5. Serum Albumin:

17. TREATMENT

18. 1

19. (RhoGAM): This is the primary preventive strategy.
Anti-D immunoglobulin is administered to Rh-
negative mothers during pregnancy and after delivery
to prevent sensitization to Rh-positive blood.
2.Administration of Anti-D Immunoglobulin
: Helps reduce bilirubin levels in the newborn and
prevents kernicterus (brain damage caused by excessive
bilirubin).
Phototherapy: 3

20. This can help reduce the need for exchange
transfusion by neutralizing maternal antibodies in
the newborn's circulation.
4.Intravenous Immunoglobulin (IVIG
In cases where the fetus is anemic, intrauterine blood
transfusions are performed to correct fetal anemia. This
is typically done through the umbilical vein and can
significantly improve fetal outcomes.
5. Intrauterine Transfusion (IUT):

21. Amniotic fluid analysis may be performed to
assess bilirubin levels, which can indicate the
severity of hemolysis in the fetus.
6.Amniocentesis:
After birth, an exchange transfusion may be performed
to remove the baby's Rh-positive blood and replace it
with Rh-negative blood. This helps in removing the
antibodies and bilirubin from the infant's blood,
preventing further hemolysis and jaundice.
7.Exchange Transfusion