Rh incompatibility

Alternative names:

hydrops fetalis; kernicterus; Rh-induced hemolytic disease of the newborn

Symptoms:

• Rh positive infant delivered of an Rh negative mother
• slowly or rapidly increasing jaundice
• prolonged jaundice
• hypotonia
• motormental retardation
• polyhydramnios

Signs and tests:

Mild Rh incompatibility:

• positive direct Coombs
• evidence of hemolysis in the infant's blood
• elevated cord blood bilirubin

Hydrops fetalis:

• severe anemia
• heart failure (cardiac failure)
• enlarged liver (hepatomegaly)
• respiratory distress
• bruising or purplish bruise-like lesions on the skin (purpura)

Early:

• high bilirubin level (greater than 18 mg/cc)
• extreme jaundice
• absent Moro (startle) reflex
• poor suck
• lethargy

Mid:

• high-pitched cry
• arched back with neck hyperextended backwards (opisthotonos)
• bulging fontanel (soft spot)
• seizures

Late--full neurological syndrome:

• high pitched hearing loss
• mental retardation
• muscle rigidity
• speech difficulties
• seizures
• movement disorder