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Rh incompatibility

• Overview
• Symptoms
• Treatment
• Prevention

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 blood bilirubin

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: 8/18/2006
• Reviewed By: Benjamin W. Van Voorhees, MD, MPH, Assistant Professor of Medicine and Pediatrics, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.

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