Erythroblastosis fetalis as a cause of fetal mortality

Abstract

Two and possibly three cases of erythroblastosis fetalis are described. They were the only outwardly normal full-term or near full-term infants received in the embryology laboratory, and two of the three were found to be cases of erythroblastosis fetalis when examined at autopsy, although the infants had been regarded as normal by the obstetrician. It is suggested that this condition may be a cause of many stillbirths at or near term, and of many deaths formerly attributed to prematurity and it may go unrecognized because it does not always cause external manifestations, such as hydrops or jaundice. The obstetrician may receive blame for mismanagement of the case because of the death of the infant. The lives of some of these children might be saved by induction of labor while the fetus is still viable, followed by transfusion, if the obstetrician is aware that the mother has given birth to other offspring with erythroblastosis. Such knowledge will be gained only by subjecting all stillbirths, premature infants and outwardly normal fullterm infants, dying immediately after birth, to routine pathologic inspection. Just as “senility” has given way to a more adequate classification in most cases, so “stillbirths” and “prematurity” will give way to more accurate cataloguing as the causes of death are more scientifically determined.