TY - CHAP M1 - Book, Section TI - Alloimmune Hemolytic Disease of the Fetus and Newborn A1 - Fasano, Ross M. A1 - Hendrickson, Jeanne E. A1 - Luban, Naomi L.C. A2 - Kaushansky, Kenneth A2 - Prchal, Josef T. A2 - Burns, Linda J. A2 - Lichtman, Marshall A. A2 - Levi, Marcel A2 - Linch, David C. Y1 - 2021 N1 - T2 - Williams Hematology, 10e AB - SUMMARYAlloimmune hemolytic disease of the fetus and newborn is caused by the action of transplacentally transmitted maternal immunoglobulin (Ig) G antibodies on paternally inherited antigens present on fetal red cells but absent on the maternal red cells. Maternal IgG antibodies bind to fetal red cells, causing hemolysis or suppression of erythropoiesis. As a consequence, anemia, extramedullary hematopoiesis, and neonatal hyperbilirubinemia may result, with severe cases resulting in fetal loss or neonatal death or disability. Collaboration among maternal–fetal medicine specialists, hematologists, transfusion medicine physicians, radiologists, and neonatologists has substantially reduced perinatal mortality and morbidity resulting from hemolytic disease of the fetus and newborn. Antenatal diagnostic methods identify at risk fetuses and assess disease severity in affected fetuses. After birth, phototherapy and exchange transfusions prevent serum bilirubin from rising to levels that could produce bilirubin encephalopathy and resultant brain damage (kernicterus), remove maternal antibody, and replace circulating fetal red blood cells with those negative for the implicated antigen(s). Rho(D) immunoglobulin (RhIg) has successfully prevented alloimmune hemolytic disease resulting from rhesus D sensitization in many at risk infants, but there is not enough RhIg available to distribute to all women at risk worldwide, and no prophylactic therapy exists as of this writing to prevent alloimmune hemolytic disease resulting from other red cell antibodies. Advances in immunohematology and molecular biology may offer new avenues for prevention and treatment in the future. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1178742736 ER -