If you are pregnant and at risk of having a baby with hemolytic disease of the fetus and newborn (HDFN), you will likely receive reinforced care throughout your pregnancy. Similarly, if your baby is diagnosed with HDFN, you will likely receive care from a team of specialists throughout your pregnancy and delivery.
HDFN is a rare red blood cell disease in which a pregnant mother and her baby have mismatched blood types or factors, most commonly due to RhD or ABO incompatibility. The mother can develop antibodies that attack her baby’s blood in a process called maternal alloimmunization.
The effects of HDFN are most often minor and can include mild anemia, jaundice and kernicterus. The most severe outcomes include brain damage in the newborn or stillbirth, though these are rare.
With the right treatment plan and preventative measures in place, many infants and newborns with HDFN make a full and quick recovery after delivery.
Learn more about HDFN treatment and care
Prenatal care following HDFN diagnosis
While the potential for HDFN is recognized in first pregnancies, it often also occurs in subsequent pregnancies. However, in cases of hemorrhages, amniocentesis or in-utero therapeutic interventions, the mother’s blood can be sensitized. Antibodies can then cross the placenta to attack the baby’s blood, breaking down the blood cells and leading to anemia.
A clear treatment plan is essential if your baby has been diagnosed with HDFN. While you must be able to trust your healthcare team, it is also important for you to stay well-informed on your diagnosis. In most cases, the treatment protocol includes the following:
Doppler ultrasounds
Your healthcare team will likely monitor the progression of HDFN in your baby with weekly noninvasive fetal middle cerebral artery (MCA) peak systolic velocity (PSV) Doppler ultrasounds. These measure the blood flow to the fetal brain.
Intrauterine blood transfusions
If the MCA PSV is considered to be at a critical level because your baby is presenting with fetal anemia, an intrauterine blood transfusion may be recommended. If this is the case, your baby will be given some medication to calm all fetal movement during the procedure. It is administered with an injection in the abdomen and into the umbilical cord.
The objective is to maintain your baby’s health until delivery, so more than one transfusion may be necessary during your pregnancy.
Early delivery
In some cases, early delivery may be either a consequence of an intrauterine blood transfusion or may be necessary to prevent HDFN from worsening in the womb. It is not uncommon for babies with HDFN to be delivered between 34 and 37 weeks gestation.
Babies affected by HDFN who receive timely treatment both in utero and post-delivery rarely experience long-term effects. Over 95% of babies with HDFN recover and develop normally.
