Erythroblastosis Fetalis

WHAT YOU SHOULD KNOW:

• Erythroblastosis fetalis (e-RITH-ro-blas-toe-sis FEE-tal-is) is a condition that can cause anemia (low red blood cell count) in babies. It is also called hemolytic disease of the newborn (HDN) and is a condition babies get before birth. Erythroblastosis fetalis occurs when you and your baby have blood differences, such as Rh factor or ABO type. This condition happens after some of the baby's blood gets into the mother's blood. That can cause the mother's body to make antibodies that can destroy the baby's red blood cells (RBCs). Antibodies are a part of your body's immune system (body's defense). The antibodies can cross over to your baby through the placenta (organ in the womb that connects baby to mother). These antibodies may stay in your baby's blood for some time after he is born.
  
  
• Your baby with erythroblastosis fetalis may have been treated for it before he was born. He may have had blood transfusions while in the womb. He may have needed to be delivered sooner than his expected due date. He may be born with paleness or a swollen body. He may have jaundice (yellow color to skin or eyes) at birth or get it soon after being born. Blood tests may be done to check for erythroblastosis fetalis before or after your baby is born. Treatment for your baby may include phototherapy, immune globulin medicine, or a blood exchange transfusion. With monitoring and early treatment, further medical problems caused by erythroblastosis fetalis may be prevented or lessened.

CARE AGREEMENT:

You have the right to help plan your baby's care. Learn about your baby's health condition and how it may be treated. Discuss treatment options with your baby's caregivers to decide what care you want for your baby.

RISKS:

• Treatment for erythroblastosis fetalis may cause unwanted effects. Your baby could get an infection or bleed from getting blood transfusions while in the womb. Any treatments with blood products, such as blood transfusions or IVIG may bring an infection. He may have breathing or other problems if he was born earlier than he was expected to be. Your baby's eyes may get injured with phototherapy for his jaundice. He may get dehydrated (lose too much body fluid) with phototherapy or becomes too warm. He may react to getting IVIG with breathing problems, seizures, liver problems, or kidney problems. Having an exchange transfusion may bring problems for your baby, including some life-threatening ones. These include having problems with bleeding, heart beat or breathing problems, or decreased blood flow to his intestines.
  
  
• Without treatment, erythroblastosis fetalis causes other problems that may be life-threatening. Your baby may have anemia that can lead to decreased oxygen to his brain, heart, and other organs. Your unborn baby may get hydrops fetalis, a condition where his whole body swells with fluid. With this he may also have heart failure or problems with bleeding too much. Increased bilirubin in your baby's blood is what makes him jaundiced. A bilirubin level that gets too high can cause hearing loss or brain damage, and may be life-threatening. Early diagnosis of erythroblastosis fetalis, close monitoring, and treatment are very important. Ask your caregiver if you are worried, or have questions about your baby's condition, medicine, or care.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

IV:

An IV is a small tube placed in your child's vein. Caregivers use the IV to give your child medicine or liquids.

Medicines:

Your baby may be given any of the following kinds of medicines:

• Immune globulin: Immune globulin given intravenous (IV) is also called IVIG. This medicine helps to keep your baby's RBCs from being damaged by antibodies made by the mother's body. Getting this treatment may reduce his chances of needing an exchange transfusion. Ask your caregiver for more information about how immune globulin medicine may help your baby.
  
  
• Improving bile flow: Bilirubin is removed from your baby's body in bile, a digestive fluid made by his liver. The bile carries the bilirubin into his intestines where he gets rid of it in his bowel movements. He may be given medicine that increases the flow of bile into his intestines.

Tests:

• Blood tests: Your baby may need blood taken for tests. The blood may be taken from the umbilical cord when he is born. If your baby is sick at birth, he may have a catheter (small tube) placed for intravenous (IV) fluids and blood draws. This may be placed in his umbilical cord stump and is called an umbilical venous catheter (UVC). Your baby's blood may be checked for blood type, antibodies, RBC count, and bilirubin level. Your baby may need to have blood drawn more than once.
  
  

Treatment options:

Your baby may have any of the following:

• Phototherapy: This treatment uses special bright lights to help break down and get rid of the bilirubin in your baby's body. As his bilirubin level decreases, his skin will lose its yellow color. Depending on how high his bilirubin level is, phototherapy may be used all of the time, or only sometimes. Ask your caregiver for more information about phototherapy for jaundice in newborns.
  
  
• Immune globulin: Immune globulin given IV is also called IVIG. This medicine helps to keep your baby's RBCs from being damaged by antibodies made by the mother's body. Getting this treatment may reduce his chances of needing an exchange transfusion. Ask your caregiver for more information about how immune globulin medicine may help your baby.
  
  
• Exchange transfusion: This is a procedure to remove the antibodies attacking his RBCs and some of the bilirubin. Small portions of your baby's blood will be removed and replaced with donor blood. You may be worried that your baby may get AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risks of this happening are rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus. This procedure may need to be done more than once. Ask your caregiver for more information about exchange transfusion in newborns.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Erythroblastosis Fetalis (Inpatient Care)