Question

A. Fully describe how erythroblastosis fetalis can be manifested.   

Answer 1

It is a hemolytic disease of newborn which occurs due to Rh incompatibility when an Rh negative mother carries Rh posituve fetus during pregnancy.

• Usually no reaction occurs in the first pregnancy.At the time of delivery during placental seperation,a small amount of fetal blood leaks into the maternal circulation/this induces formation of anti Rh agglutinins in the mother.
• so in subsequent pregnancies,the anti Rh agglutinins from mother,which is predominantly IgG type crosses placenta to enter into fetal circulation and causes hemolysis.
• In third and subsequent pregnancies,the degree of hemolysis become severe.
• Clinical features of erythroblastosis fetalis are due to hemolysis.Hemolysis leads to Anemia.
• Extramedullary hemopoeisis and neonatal hyperbilirubinemia.If the hemolysis is severe,the fetus may die in utero.
• In severe cases of erythroblastosis fetalis the major modalities of treatment are intrauterine fetal transfusion,exchange transfusion and phototherapy.