ABO incompatibility

• the mother is O and the fetus is B or A or AB. (most common- represents almost 100 percent of the cases)
• the mother is A and the fetus is B or AB (extremely uncommon)
• the mother is B and the fetus is A or AB (extremely uncommon)

In these cases, the mother creates antibodies against the fetus' incompatible blood type. These antibodies cross the placenta into the fetus' blood stream where they begin to destroy the fetus' blood cells.

ABO incompatibility is similar to Rh incompatibility but generally creates much milder problems than Rh incompatibility. Newborn infants affected by ABO incompatibility may have elevated levels of bilirubin and become jaundiced (whites of the eyes and skin become yellow). Severe ABO incompatibility problems may require an exchange transfusion . However, most ABO incompatibility is relatively minor and the jaundice it produces can usually be treated with bili-lights ( phototherapy ).

Prevention:
Prevention is not practical. Early recognition of an incompatibility allows for easy and inexpensive treatment.

Symptoms:

• incompatible maternal and fetal blood type
• jaundice in the newborn

Signs and Tests:

• cord blood test for direct Coombs test
• CBC shows damaged and hemolyzed red blood cells, may also show spherocytosis and a mild anemia
• bilirubin level is elevated

Treatment:

Phototherapy with bili-lights standard treatment for the elevated bilirubin and jaundice . On rare occasion an exchange transfusion may be indicated.

Prognosis:

Full recovery is expected without residual or permanent problems.

Complications:

• anemia (uncommon)
• kernicterus (extremely rare)

Call Your Healthcare Provider:

You were released from the hospital after a "short stay" (less than 48 hours) and your newborn infant becomes significantly jaundiced, especially if your blood type is O.


Newborn jaundice (producing yellow skin) can have many causes, but the majority of these infants have a condition called physiological jaundice, a natural occurrence in the newborn due to the immature liver. This type of jaundice is short term, generally lasting only a few days. Jaundice persisting longer than 3 to 4 days, or worsening rapidly, should be evaluated by a physician until decreasing or normal levels of bilirubin are measured in the blood.