Clinical experience with hemolytic disease of newborn infants.

Abstract

The results achieved in caring for 251 infants with hemolytic disease secondary to Rh blood group incompatibility varied significantly according to the infants' age when first available for treatment. Treatment was aimed to maintain the total serum bilirubin level below 20 mg. per 100 ml. during the first five days of life. A cure was achieved in 97% of those infants first seen prior to their age of 12 hours and the five failures encountered in this group of infants were deaths occuring among babies born critically ill. The percentage of failures among the infants who were referred after age 12 hours was 12% and the type of failure encountered was most frequently an infant who survived with cerebral palsy. Fifty-six of the infants available for treatment early were babies born to women who had had a previous infant with hemolytic disease secondary to an Rh blood group incompatibility. Fifty-three of these infants did well and three died. Therefore one is not justified in the great majority of instandes in recommending that a sensitized woman not risk a future pregnancy. Because of a significantly higher percentage of failures encountered in premature infants and because of the difficulty in being certain that a previously sensitized woman is carrying an infant with hemolytic disease, warning is given against the indiscriminate use of early termination of pregnancy in the management of this disease. This approach should be used only in carefully selected cases.