II. Pathophysiology

  1. Maternal Rh Sensitization
    1. Maternal anti-Rh Antibodies are present in newborn plasma
  2. Results in fetal Hemolytic Anemia (Alloimmune Hemolytic Anemia)
    1. Increased Unconjugated Hyperbilirubinemia
    2. Compensating Erythropoiesis
    3. Hepatosplenomegaly
      1. Red Blood Cell production and destruction
    4. Placenta enlarged
  3. Additional Risk Factors
    1. G6PD Deficiency (highest risk for Kernicterus)

III. Labs

  1. Direct Antibody Test (Direct Coombs test) positive

V. Complications

  1. Fetal hydrops
  2. Hemolytic Anemia
  3. Congenital Anemia (Mild Hemolysis)
  4. Icterus Gravis (Severe Hemolysis)
  5. Kernicterus

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