Erythroblastosis fetalis is an example of an autoimmune disease caused due to the incompatibility of the mother’s body with the Rh factor. Before we move into the actual topic let me give you a general idea on what Rh factor is! 

Rh FACTOR

Erythroblastosis Fetalis
  • Rh (Rhesus – named after rhesus monkey) antigen/ factor was discovered by Landsteiner and Wiener.
  • Rh factor is a protein that is (dominant inherited character) found on the surface of red blood cells.
  • The presence or absence of the protein in your blood makes your blood Rh positive or Rh negative.
  • The absence of the Rh factor does not affect your health in any way.
  • Rh-positive blood cannot be donated to an Rh-negative person since it will lead to antigen-antibody reaction ultimately leading to Hemolysis ( destruction of RBCs).
  • Special care is needed only during pregnancy, that too only if the mother is Rh negative while the baby is Rh positive.

Rh factor and Pregnancy

This happens when the foetus is Rh positive and the mother is Rh negative (condition: Rh +ve ♂ + Rh -ve ♀ = Rh +ve offspring).

The first child is usually unaffected in this case but during labour, a small portion of the foetus’ blood may mix with the mother’s bloodstream. This causes the mother’s body to react to the foreign protein and produce antibodies which will affect the Rh incompatible offspring in the subsequent pregnancies. 

Father’s RhMother’s RhFetus’ Rh
PositivePositive Positive 
Positive Negative Positive 
Negative Positive Positive 
Negative Negative Negative 

Effects

  • Miscarriage
  • Ectopic pregnancy
  • Abortion
  • A benign tumour in the uterus
  • Bleeding during pregnancy
  • Change in baby’s position.

The most common effect of Rh incompatibility is “ERYTHROBLASTOSIS FETALIS”.

Erythroblastosis Fetalis

Erythroblastosis fetalis is a hemolytic disorder that occurs in the foetus due to the Rh incompatibility with the mother. The red blood cells of the foetus are destroyed by the maternal immune system. Rh antigen present in the child’s bloodstream is considered as a foreign particle by a Rh -ve mother’s immune system and it produces antibodies to neutralise the “threat”.

The antibodies produced react with the Rh antigen ( on the surface of RBCs) and lead to clumping or agglutination of fetal RBCs and finally lysis of the red blood cells. As mentioned earlier the first child if the Rh incompatible parents is not affected since the amount of foetal Rh entering the mother’s bloodstream during pregnancy is not sufficient to cause a reaction, whereas during labor there is a significantly high exposure of mother’s blood to the rh factor hence resulting in Erythroblastosis fetalis in the subsequent pregnancies.

Symptoms of Erythroblastosis Fetalis

  • Reduced RBC count in the foetus
  • Anaemia
  • Liver and spleen enlargement
  • Jaundice ( eye and skin turn yellow) in the newborn.
  •  The buildup of fluid in the abdomen, lungs or scalp in the foetus.
  • High bilirubin levels.

DIAGNOSIS

 FOETAL TESTING

  • Ultrasound
  • Amniocentesis
  • Testing cerebral blood flow.
  • Umbilical cord blood testing.

NEWBORN TESTING

  • Blood group or Rh testing
  • Red blood cell count
  • Antibody level
  • Bilirubin level measurement.

TREATMENT

Erythroblastosis fetalis can be prevented by injecting the mother with Rh immunoglobulin which suppresses the maternal immune response against the Rh antigen. But this must be done within a stipulated time limit,

  • 72 hours after delivering the first Rh +ve offspring.
  • Within 72 hours of abortion, miscarriage etc.,
  • After any sort of vaginal bleeding
  • At the 7th month of gestation.

Treatment for newborns

  • Blood transfusion
  • IV immunoglobulins( reduces the lysis of RBCs). 
  • Supplement of intravenous fluids

Bonne Lecture 🙂

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