Rh incompatibility

Injury	Disease	Nutrition	Poison

Symptoms	Surgery	Test	Special Topic

Erythroblastosis fetalis, photomicrograph

Jaundice infant

Antibodies

Exchange transfusion - series

Overview

Symptoms

Treatment

Prevention

Rh incompatibility

Alternative Names:

Rh-induced hemolytic disease of the newborn; Hydrops fetalis

Symptoms:

Polyhydramnios (before birth)
Slowly or rapidly increasing jaundice
Prolonged jaundice
Hypotonia
Motormental retardation

Signs and tests:

Mild Rh incompatibility:

Positive direct Coombs
Evidence of hemolysis in the infant's blood
Elevated cord bloodbilirubin

Hydrops fetalis:

Severe anemia
Heart failure (cardiac failure)
Enlarged liver (hepatomegaly)
Respiratory distress
Bruising or purplish bruise-like lesions on the skin (purpura)

Kernicterus -- Early:

High bilirubin level (greater than 18 mg/cc)
Extreme jaundice
Absent Moro (startle) reflex
Poor breast-feeding or sucking
Lethargy

Kernicterus -- Mid:

High-pitched cry
Arched back with neck hyperextended backwards (opisthotonos)
Bulging fontanel (soft spot)
Seizures

Kernicterus -- Late (full neurological syndrome):

High-frequency hearing loss
Mental retardation
Muscle rigidity
Speech difficulties
Seizures
Movement disorder

Review Date: 7/15/2004
Reviewed By: John Goldenring, M.D., MPH, Department of Pediatrics, Children's Hospital, San Diego, CA. Review provided by VeriMed Healthcare Network.

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