Erythroblastosis Fetalis
Question. Write short note on erythroblastosis fetalis.
Answer. Erythroblastosis fetalis is a hemolytic anemia of newborns secondary to blood incompatibility mainly Rh factor between the mother and fetus.
Currently this disorder is uncommon due to use of anti antigen gamma globulin at delivery in mothers with Rh-negative blood.
“Pathophysiology of erythroblastosis fetalis explained”
Pathogenesis
It occurs due to the inheritance by the fetus of a blood factor from Rh positive father which act as foreign antigen to Rh negative mother.
Transplacental leak of RBCs from fetus to mother leads to immunization of mother and formation of antibodies which are transferred back to fetus transplacentally, this leads to fetal hemolysis.
erythroblastosis fetalis
“Impact of maternal antibodies on fetal red blood cells”
Clinical Features
- Features depend on the severity of hemolysis, if it is severe child is stillborn or dead.
- Alive born child suffer from anemia with pallor, jaundice, compensatory erythropoiesis, i.e. medullary and extramedullary and edema.
“Role of Rh incompatibility in erythroblastosis fetalis”
Oral Manifestations
- Deposition of blood pigments in enamel and dentin of neonate which produces green, brown or blue hue.
- Enamel hypoplasia can also be present.
- A ring-like defect is present at incisal edges of deciduous anterior teeth and middle portion of deciduous cuspid and fist molar crown known as Rh hump.
“Jaundice in erythroblastosis fetalis explained”
Histopathology
Ground section of the affected teeth shows positive test for bilirubin.
Laboratory Findings
- RBC count at birth is from 1000000 cells/cu mm to normal level.
- Peripheral smear shows normoblasts or nucleated red cells.
- High bilirubin level.
- Direct Coombs test on cord blood is positive
hemolytic disease of the newborn
“Treatment options for erythroblastosis fetalis”
Treatment
No treatment is needed as the condition affects only deciduous teeth and not the permanent teeth.
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