Hemolytic Disease of the Newborn- Review

Hemolytic disease of the newborn (HDN), with high potential for increased fetal loss is less common now, due to the universal screening for iso-sensitization and also because of appropriate use of antenatal anti-Rh D antibody prophylaxis. There are other non-Rh D antibodies that can cause HDN. In US, we occasionally encounter a highly sensitized fetus resulting in significant morbidity and mortality. In utero RBC transfusions and Intravenous Immunoglobulin (IVIG) therapy for such an infant are effective to some extent, in the management of HDN. Partial exchange transfusions (immediately after the delivery) and double volume exchange transfusions are rarely but still, needed as rescue modes. A coordinated, well planned and executed effort between the perinatal center and the community health care team is essential for the optimal outcome of such pregnancies. It is also essential to realize the importance and effectiveness of Universal screening.