Haemolytic disease of the fetus and newborn (HDFN)

Why haemolytic disease of the fetus and newborn (HDFN) happens

Haemolytic disease of the fetus and newborn (HDFN) can happen when you have a certain blood type (D negative) that's different to your baby's blood type (D positive).

This may mean you have antibodies that can break down your baby's red blood cells.

You might have antibodies if you've come into contact with D positive blood before, for example during:

• a blood transfusion
• a previous pregnancy

Screening for haemolytic disease of the fetus and newborn (HDFN)

Haemolytic disease of the fetus and newborn (HDFN) is routinely screened for during pregnancy. You'll be offered a blood test at your first antenatal appointment at 8 to 12 weeks.

If the results of the blood test show your blood type is:

• D positive, there's no risk of HDFN
• D negative, your baby's blood type will be tested using a sample of your blood

If the results show your baby’s blood type is:

• D negative, then there's no risk of HDFN
• D positive, you’ll be offered an injection (anti-D prophylaxis) to stop you developing antibodies

Signs of haemolytic disease of the fetus and newborn (HDFN)

If you already have antibodies and your baby is D positive, there's a risk of haemolytic disease of the fetus and newborn (HDFN) and the anti-D injections will not work.

You will then be offered extra scans and blood tests to help monitor your baby.

After they're born, your baby will continue to be monitored, to look for signs of  jaundice and anaemia.

Symptoms of jaundice include:

• skin or whites of the eyes turn yellow – on brown or black skin, this is easier to see on the palms of the hands or soles of the feet
• dark yellow urine or pale-coloured poo
• being sleepy, and not wanting to feed or not feeding as well as usual

Symptoms of anaemia include:

• pale skin – on brown or black skin, this is easier to see on the fingernails or the insides of the eyelids
• breathing more quickly than usual
• being sleepy, and not wanting to feed or not feeding as well as usual

Contact your doctor, midwife or health visitor urgently if:

You've been told your baby may have HDFN and:

• they have symptoms of jaundice or anaemia

Treating haemolytic disease of the fetus and newborn (HDFN)

If your baby is diagnosed with haemolytic disease of the fetus and newborn (HDFN), your midwife or doctor will discuss the treatment options with you. They'll explain what will happen, as well as the benefits and risks.

Treatment during pregnancy includes blood transfusions for your baby.

If your baby develops anaemia later on in the pregnancy, you may need to have a C-section before your due date.

Treatment for newborns includes:

• light therapy on your baby's skin for jaundice
• your baby's blood is replaced with donated blood (exchange blood transfusion)

The risk of complications is low because the treatments are usually very effective.

But if your baby is very unwell, they may need to be treated in a neonatal intensive care unit.

Haemolytic disease of the fetus and newborn (HDFN)

Causes

Haemolytic disease of the fetus and newborn (HDFN)

Prevention

Haemolytic disease of the fetus and newborn (HDFN)

Symptoms

Haemolytic disease of the fetus and newborn (HDFN)

Medical treatments

Haemolytic disease of the fetus and newborn (HDFN) can happen when a mother's blood type is D negative and her baby's is D positive.

Haemolytic disease of the fetus and newborn (HDFN) is screened for in pregnancy. You can have injections to protect your baby if they're at risk.

Haemolytic disease of the fetus and newborn (HDFN) can cause newborn jaundice. Symptoms include yellowing of the whites of the eyes and pale poo.

Treatments for haemolytic disease of the fetus and newborn (HDFN) include blood transfusions, and immunoglobin or light therapy treatments.