Erythroblastosis Fetalis and Hydrops Fetalis

  • Kurt Benirschke
  • Peter Kaufmann


Erythroblastosis fetalis, or hemolytic disease of the newborn, is a condition caused by specific antibodies of the mother directed against red blood cell antigens of the fetus. They are largely Rh-(D) antigens, but rare cases of sensitization against other antigens (e.g., Kell), and ABO incompatibility with fetal hemolytic disease have been described. Leventhal and Wolf (1956) have presented Kell isoimmunization as a cause of fatal erythroblastosis (EF). This form was also found in the well illustrated case of Ivemark et al. (1959). Anti-K antibodies usually arise as a result of transfusion, and the fetal disease is usually mild. Of 194 pregnancies complicated by this antibody constellation, only 16 affected babies were identified, of which 3 were severely affected by hemolytic disease (Leggat et al., 1991). The difficulty in this situation is the identification of the pregnancies at risk, an aspect discussed in some detail in an Editorial (1991). Anti-K hemolytic disease does not differ pathologically from the erythroblastosis caused by anti-D. Relatively few cases of typical, severe EF have been described as being due to ABO incompatibility. These cases are summarized by Freda and Carter (1962), and a fatal case is delineated in the paper by Miller and Petrie (1963); but usually the hemolytic disease of ABO incompatibility is mild. The pathological findings of infant and placenta are the same as those in EF due to Rh incompatibility; in the case described by Miller and Petrie, the placenta weighed 900g and had typical features of erythroblastosis. Other types of hemolysis occur that produce similar pathological features of infant and placenta. Thus hemolysis in fetal blood may rarely result because of glucose-6-phosphate dehydrogenase (G-6-PD) deficiency, virus infection, or for other uncommon reasons. These causes of fetal hemolysis must be differentiated from the classical erythroblastosis.


Hydatidiform Mole Hemolytic Disease Fetal Hydrops Sacrococcygeal Teratoma Chorionic Villous Sampling 
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Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • Kurt Benirschke
    • 1
  • Peter Kaufmann
    • 2
  1. 1.University Medical CenterUniversity of California, San DiegoSan DiegoUSA
  2. 2.Institut für Anatomie der Medizinischen FakultätRheinisch-Westfälische Technische Hochschule AachenAachenGermany

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