Learn The BasicsHemolytic disease of the fetus and newborn (HDFN) is a rare disease that occurs during pregnancy that can be associated with a number of complications. To prevent this, early diagnosis and treatment by a team of specialists is of utmost importance.
Both the mother and the newborn should be considered and cared for at all times. Because of this, the management of the disease requires close collaboration between the OB/GYN and pediatric providers as well as blood bank personnel.
The care team
The specialist care team for HDFN includes:
- An OB/GYN.
- A neonatologist.
- A pediatric and fetal surgeon.
- A pediatric hematologist.
- A transfusion specialist.
- A clinical geneticist.
The OB/GYN
The OB/GYN is the first point of contact for a pregnant woman. They can identify risk factors associated with HDFN such as Rh incompatibility. In cases where there is a high risk of HDFN, the OB/GYN closely monitors the pregnancy for any complications.
The neonatologist
A neonatologist is a doctor who specializes in the treatment of newborns. They will assess the breathing and heart rate of the baby at birth and examine them for any other possible complications.
In case the baby requires treatment for HDFN, the neonatologist will oversee the management of the disease, which may include phototherapy, intravenous fluids and blood transfusion.
The pediatric and fetal surgeon
The pediatric and fetal surgeon may need to operate on the fetus or the newborn. For example, they may need to perform an intrauterine blood transfusion to treat severe anemia that may be caused by the pregnant woman’s immune system attacking her baby’s red blood cells.
The pediatric hematologist
A pediatric hematologist specializes in the care of all children with blood disorders. They play a key role in the assessment of babies affected by HDFN and the treatment course to be taken such as blood transfusion to treat severe anemia.
The transfusion specialist
The transfusion specialist plays a crucial role in the care of babies affected by HDFN, including blood product selection, compatibility testing and transfusion strategies. They work closely with the other members of the care team to ensure the transfusion is done safely.
The clinical geneticist
The clinical geneticist can offer information about the genetic cause of the disease. They can also provide information about the potential risks for future pregnancies and options for genetic testing.
Facilities needed
Facilities should offer early diagnosis, any necessary intrauterine transfusion and support for high-dependency neonates such as the neonatal intensive care unit. The facilities needed for early diagnosis of HDFN include a laboratory where blood typing, crossmatching, antibody screening and bilirubin testing can be performed.
The neonatal intensive care unit is where specialized care can be provided for newborns who are critically ill. This care often includes phototherapy, advanced monitoring and respiratory support equipment. Access to a well-equipped blood bank is also essential so that compatible blood products for transfusion can be easily reached.
Reviewed by Harshi Dhingra, M.D., on September 30, 2023.
