Rh incompatibility

Alternative names:

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

Treatment:

Since Rh incompatibility is almost completely preventable with the use of RhoGAM, prevention remains the best treatment. Treatment of the already affected infant depends on the severity of the condition.

Mild:

• increase of fluids
• phototherapy using bilirubin lights

Hydrops fetalis:

• amniocentesis to determine severity
• intrauterine fetal transfusion
• early induction of labor
• a direct transfusion of packed red blood cells (compatible with the infant's blood) and also exchange transfusion of the newborn to rid the blood of the maternal antibodies that are destroying the red blood cells.
• control of congestive failure and fluid retention

Kernicterus:

• exchange transfusion (may require multiple exchanges)
• phototherapy

Expectations (prognosis):

Full recovery is expected for mild Rh incompatibility. Both hydrops fetalis and kernicterus represent extreme conditions caused by hemolysis. Both have guarded outcomes. Hydrops fetalis has a high mortality rate.

Complications:

• neurological syndrome with mental deficiency, movement disorder, hearing loss, speech disorder and seizures
• death

Calling your health care provider:

Call your health care provider if you think or know you are pregnant and have not yet seen a doctor.