The first pregnancy, the one that induces maternal sensitivity evolves normally. Ulterior pregnancies are characterized by hemolytic disease in the fetus, leading to anemia, immature fetal red blood cells released into circulation, hypoalbuminemia caused by hepatic dysfunction, high-output heart failure and ultimately fetal death. The amniotic fluid is rich in bilirubin and has a yellowish color. Fetal echography shows evidence of hydrops: pericardial and pleural effusions and ascites. Hydrops does not occur until the hemoglobin level drops to 4 g/dl. The biophysical profile becomes worse as the disease progresses. The severity of the hemolytic disease can be predicted using Liley diagrams [1].

If the disease is not as severe and the fetus survives, the newborn develops icterus during the first day of life, that may be as severe as to induce kernicterus. Also, the newborn will be anemic and pale and present splenomegaly and hepatomegaly, caused by extramedullary hematopoiesis. Portal hypertension has the same cause.

The placenta will be enlarged, and transplacental transport is compromised by the edema.

The mother is asymptomatic during the pregnancy and after delivery.

• Splenomegaly

  Also, the newborn will be anemic and pale and present splenomegaly and hepatomegaly, caused by extramedullary hematopoiesis. Portal hypertension has the same cause. [symptoma.com]

  The destruction of the red blood corpuscles is responsible for the morbus haemolyticus neonatorum (fetal erythroblastosis) with the following symptoms: anemia (due to the hemolysis) splenomegaly (location of the macrophages that destroy the erythrocytes [embryology.ch]

• Anemia

  It is a disorder due to blood group incompatibility, such as the maternal alloimmunization by fetal antigen rh factors leading to hemolysis of erythrocytes, hemolytic anemia (anemia, hemolytic), general edema (hydrops fetalis), and severe jaundice in [icd9data.com]

  […] and severely anemia fetuses (thick line). [emedicine.medscape.com]

  We report a case of hemolytic disease of the fetus and newborn along with prolonged anemia in newborn twins that persisted for up to 70 days postbirth. [ncbi.nlm.nih.gov]

  Da Wikimedia Commons, l'archivio di file multimediali liberi Jump to navigation Jump to search eritroblastosi fetale malattia fetale Carica un file multimediale Wikipedia Istanza di malattia Sottoclasse di neonatal alloimmune disease, anemia microcitica [commons.wikimedia.org]

• Swelling

  Symptoms of Erythroblastosis Fetalis Symptoms that may occur before the baby is born: Swelling of the baby’s body Rapid heart rate Enlarged organs such as the spleen, liver, or heart Symptoms that may occur after the baby is born: Difficulty breathing [medicalbite.com]

  HDN can destroy the newborn baby's blood cells very quickly, which can cause symptoms such as: Edema (swelling under the surface of the skin) Newborn jaundice which occurs sooner and is more severe than normal Signs of HDN include: Anemia or low blood [nlm.nih.gov]

  These compartments or spaces can be fluid collection in the abdominal cavity (ascites), around the heart (pericardial effusion), and/or lungs (pleural effusion), or generalized edema or swelling of the skin and throughout the body (anasarca), as well [usmleforum.com]

  For infants without any specific diagnosis, we offer supportive treatment as we give the baby time to reabsorb all the edema (fluid from swelling). [chw.org]

• Cerebral Palsy

  Babies who survive pregnancy may develop kernicterus, which can lead to deafness, speech problems, cerebral palsy, or mental retardation. Extended hydrops fetalis can inhibit lung growth and contribute toheart failure. [faqs.org]

  When the antibodies attack the red blood cells, they cause anemia and kernicterus, which can lead excess bilirubin collecting in the brain, leading to deafness, speech problems, cerebral palsy, and other forms of brain damage. [everything2.com]

  However, when a baby is born with such symptoms, it may develop cerebral palsy or mental retardation. But with careful assessment, it may be treated. Sources: 1, 2 Image Credit Virupakshi Why on earth do you need my biography? I won't say it! [factslegend.org]

  High at birth or rapidly rising bilirubin Prolonged hyperbilirubinemia Bilirubin Induced Neurological Dysfunction Cerebral Palsy Kernicterus Neutropenia Thrombocytopenia Hemolytic anemia - Must NOT be treated with iron Late onset anemia - Must NOT be [en.wikipedia.org]

  Babies who survive pregnancy may develop kernicterus, which can lead to deafness, speech problems, cerebral palsy, or mental retardation. Extended hydrops fetalis can inhibit lung growth and contribute to heart failure. [medical-dictionary.thefreedictionary.com]

• Falling

  The term erythroblastosis fetalis originates from the fact that during this removal process, the hemoglobin concentration in the patient falls due to the accelerated red cell destruction. [circuit.perfusion.com]

  - Head control may be poor or absent, with the head falling to the side, backward/forward, [de.slideshare.net]

  […] woman and the fetus to mix during pregnancy, it could happen as a result of: the placenta detaching from the wall of the uterus wall during delivery bleeding during pregnancy manual rotation of a breech baby abortion an ectopic pregnancy a miscarriage a fall [medicalnewstoday.com]

  However, it may also happen anytime blood cells of the two circulations mix, such as during a miscarriage or abortion, with a fall, or during an invasive prenatal testing procedure (such as an amniocentesis or chorionic villus sampling). [stanfordchildrens.org]

  This can occur during a miscarriage or fall. It may also happen during a prenatal test. These can include amniocentesis or chorionic villus sampling. These tests use a needle to take a sample of tissue. They may cause bleeding. [cedars-sinai.edu]

• Fever

  You develop a fever. After your baby is born: Your baby develops a fever. Your baby develops jaundice. Your baby is not feeding well or is urinating less than before. You have breastfeeding problems. [drugs.com]

  Practice Essentials Acute transfusion reactions present as adverse signs or symptoms during or within 24 hours of a blood transfusion. [1] The most frequent reactions are fever, chills, pruritus, or urticaria, which typically resolve promptly without [emedicine.medscape.com]

  Keep an eye on your newborn baby’s health: Check for the following: (i) fever; (ii) jaundice (yellowing of skin); (iii) feeding less than normal; (iv) passing less urine than normal. [medindia.net]

  The baby also usually is jaundiced, fevered, quite swollen, and has an enlarged liver and spleen. This condition is called erythroblastosis fetalis. [www2.palomar.edu]

  Symptoms The following are symptoms of transfusion reactions: Back pain Blood in urine Feeling of "impending doom" Fever Yellow skin ( jaundice ) Exams and Tests Bilirubin level is high Complete blood count (CBC) shows damaged red blood cells, may also [vjahnavi57.blogspot.com]

• Respiratory Distress

  Página 526 - Association between maternal diabetes and the respiratory distress syndrome in the newborn - Robert MF, Neff RK ‎ [books.google.es]

  After birth, treatment may include: Blood transfusions (for severe anemia) Intravenous fluids (for low blood pressure) Help for respiratory distress using oxygen, surfactant, or a mechanical breathing machine Exchange transfusion to replace the baby's [stanfordchildrens.org]

  The most common neonatal complication was jaundice in 53%, followed by respiratory distress syndrome in 28%. Two cases complicated by neonatal anemia required a postnatal blood transfusion. [doi.org]

  Untreated anemia can cause heart failure, enlarged liver and/or spleen, generalized swelling and respiratory distress. Kernicterus: This occurs due to the deposition of bilirubin in the brain and spinal cord. [medindia.net]

• Tachycardia

  Your baby may have the following symptoms: Yellow coloring of the skin and whites of the eyes (jaundice) Pale-coloring because of anemia Fast heart rate (tachycardia) Fast breathing (tachypnea) Lack of energy Swelling under the skin Large abdomen The [cedars-sinai.edu]

  Hydrops from reciprocating atrioventricular tachycardia in a 27-week fetus requiring quinidine for conversion. Obstet. Gynecol. 66 :29S–33S, 1985. [link.springer.com]

  Affected animals show lethargy, recumbency, tachycardia, and progressive icterus of eye and mouth mucosae, which rapidly leads to death. The condition is also described in newborn pigs and other animals [vjahnavi57.blogspot.com]

• Cyanosis

  This results in cyanosis and the characteristic blue coloration. Erythroblastosis fetalis, AKA Haemolytic disease of the newborn, occurs when the mother's immune system starts attacking her own fetus's blood. [everything2.com]

  […] associated with exchange transfusion has been reported in approximately 3 in 1000 procedures, 71, 72 although in otherwise well infants of 35 or more weeks’ gestation, the risk is probably much lower. 71 – 73 Significant morbidity (apnea, bradycardia, cyanosis [doi.org]

• Jaundice

  […] when the immune system of an Rh-negative mother produces antibodies to an antigen in the blood of an Rh-positive fetus which cross the placenta and destroy fetal erythrocytes and that is characterized by an increase in circulating erythroblasts and by jaundice [merriam-webster.com]

  It is a disorder due to blood group incompatibility, such as the maternal alloimmunization by fetal antigen rh factors leading to hemolysis of erythrocytes, hemolytic anemia (anemia, hemolytic), general edema (hydrops fetalis), and severe jaundice in [icd9data.com]

  Abstract Jaundice occurs in most newborn infants. [doi.org]

  Doctors also observe the newborn for jaundice. Jaundice is likely to occur because the rapid breakdown of red blood cells produces a lot of bilirubin. [merckmanuals.com]

• Hepatosplenomegaly

  […] conditions were not associated again until 1932, when Diamond et al. demonstrated that hydrops and kernicterus were two aspects of the same disease in which hemolysis of the red cells of fetuses and neonates resulted in extramedullary erythropoiesis, causing hepatosplenomegaly [doi.org]

  Pathology: Not applicable Imaging Findings: Hepatosplenomegaly, anasarca, ascites, cardiomegaly without pulmonary edema, bell shaped thoracic cage. DDX: Not applicable References: See References Chapter. [virtualpediatrichospital.org]

  […] of the anti-Rh (D) immunoglobulin to Rh- women with Rh+ newborn within 72 hours of delivery, also to Rh- women following 2nd trimestr abortion, chorionic villi sampling, amniocentesis and cordocentesis Macroscopic appearance generalized tissue edema hepatosplenomegaly [atlases.muni.cz]

  Diagnostic findings include jaundice (yellow amniotic fluid, yellow vermix, yellow skin), pallor and hepatosplenomegaly. Kernicterus (bilirubin encephalopathy) is a serious risk and hypoglycaemia is common. [patient.info]

  The newborn can present with a number of features including: clinical evidence of a fetal anemia neonatal jaundice neonatal hepatosplenomegaly generalized body edema The condition usually results from a feto-maternal blood group incompatibility such as [radiopaedia.org]

• Neonatal Jaundice

  The newborn can present with a number of features including: clinical evidence of a fetal anemia neonatal jaundice neonatal hepatosplenomegaly generalized body edema The condition usually results from a feto-maternal blood group incompatibility such as [radiopaedia.org]

  After birth, however, the immature neonatal liver is not capable of handling a high bilirubin load and this can result in severe neonatal jaundice. [patient.info]

  A controlled trial of high-intensity double-surface phototherapy on a fluid bed versus conventional phototherapy in neonatal jaundice. Pediatrics. 1995 ; 95 : 914 – 916 9. ↵ Tan KL. Phototherapy for neonatal jaundice. [doi.org]

• Hepatomegaly

  Also, the newborn will be anemic and pale and present splenomegaly and hepatomegaly, caused by extramedullary hematopoiesis. Portal hypertension has the same cause. [symptoma.com]

  […] destruction of the red blood corpuscles is responsible for the morbus haemolyticus neonatorum (fetal erythroblastosis) with the following symptoms: anemia (due to the hemolysis) splenomegaly (location of the macrophages that destroy the erythrocytes) hepatomegaly [embryology.ch]

• Hydrops Fetalis

  Nonimmunologic hydrops fetalis. Amer. J. Obstet. Gynecol. 131 :586–587, 1978. [link.springer.com]

  It is a disorder due to blood group incompatibility, such as the maternal alloimmunization by fetal antigen rh factors leading to hemolysis of erythrocytes, hemolytic anemia (anemia, hemolytic), general edema (hydrops fetalis), and severe jaundice in [icd9data.com]

  Before the initial transfusion, 11 of 43 fetuses had some degree of hydrops fetalis, and hemoglobin values ranged between 1.5 and 10.7 g/dL. [ncbi.nlm.nih.gov]

  It is a disorder due to BLOOD GROUP INCOMPATIBILITY, such as the maternal alloimmunization by fetal antigen RH FACTORS leading to HEMOLYSIS of ERYTHROCYTES, hemolytic anemia (ANEMIA, HEMOLYTIC), general edema (HYDROPS FETALIS), and SEVERE JAUNDICE IN [definitions.net]

  The remaining 25% will have severe disease and either be stillborn or have hydrops fetalis. [patient.info]

• Type A Personality

  How the genes are paired determines the person's blood type.A person who inherits an A antigen gene from each parent has type A blood; receiving two B antigen genes corresponds with type B blood; and inheriting A and B antigen genes means a person has [medigoo.com]

  How the genes are paired determines the person’s blood type. [pathologyproject.wordpress.com]

  How the genes are paired determines the person's blood type. [medical-dictionary.thefreedictionary.com]

• Seizure

  She suffered a sustained generalized tonic seizure, and was treated with phenobarbitone. Transfer to a level III neonatal intensive care unit was arranged. [doi.org]

  Your baby is having a seizure. Your baby is very irritable, fussy, and has a high-pitched cry. Your baby looks very tired or weak, or sleeps more than usual. Care Agreement You have the right to help plan your baby's care. [drugs.com]

  Hypoglycemia (low blood sugars) put these babies at risk for seizures, apnea (difficulty breathing) and possible brain injury. [chw.org]

  Other symptoms may include edema (swollen tissues), difficulty in breathing, seizures, and poor reflexes and a general lack of movement. TheLordScribe is correct regarding the need for immediate transfusion. [everything2.com]

  Later, a high-pitched shrill cry may develop along with unusual posturing, a bulging fontanel, and seizures. Infants may die suddenly of kernicterus. [womens-health.health-cares.net]

Usual prenatal consultations establish which pregnancies are at risk, namely those of Rh negative women impregnated by Rh positive men. In selected cases, blood workup will include blood type, Coombs test [2], Rh and anti-Rh antibody testing in the mother and blood type and Rh testing in the father [3]. In the mother, measurements are to be repeated every 2 weeks after 20 weeks of gestation.

The fetus is to be monitored by ultrasound regarding middle cerebral blood flow in order to determine if high output heart failure, an indicator of anemia, is present. If so, the fetal Rh should be determined by umbilical blood sampling.

Fetal Rh genotype can be tested using fetal cells or cell-free deoxyribonucleic acid in maternal circulation [4] [5] by polymerase chain reaction.

The newborn will have increased unconjugated bilirubin levels, that are rapidly rising and manifesting as icterus during the first days of life. Sometimes conjugated bilirubin levels are also high, due to hepatic dysfunction. He or she will be anemic, with increased reticulocyte count, anisocytosis, spherocytosis, and young (nucleated, immature) red blood cells released into circulation. Coombs test is positive [6]. Schistocytes, as a sign of disseminated intravascular coagulation and burr cells, are present, as well as neutropenia and thrombocytopenia. Other associated findings include hypoglycemia [7], hypokalemia or hyperkalemia and hypocalcemia. High carboxyhemoglobin levels also point to the presence of hemolysis [8].

Also, the newborn will have peripheral edema and other liquid accumulations, like ascites, pleurisy, and pericardial effusion.

• Enlargement of the Liver

  The overproduction of erythroblasts can cause the liver and spleen to become enlarged, potentially causing liver damage or a ruptured spleen. [medical-dictionary.thefreedictionary.com]

  Severe anemia with enlargement of the liver and spleen: The baby's body tries to compensate for the breakdown of red blood cells by making more of them very quickly in the liver and spleen, which causes the organs to get bigger. [medigoo.com]

  The overproduction of erythroblasts can cause the liver andspleen to become enlarged, potentially causing liver damage or a ruptured spleen. [faqs.org]

  Severe anemia with enlargement of the liver and spleen: The baby’s body tries to compensate for the breakdown of red blood cells by making more of them very quickly in the liver and spleen, which causes the organs to get bigger. [healthncare.info]

  The baby's liver is unable to handle the large amount of bilirubin that results from red blood cell breakdown. The baby's liver is enlarged and anemia continues. Kernicterus. [stanfordchildrens.org]

• Erythroblast

  […] newborn that occurs when the immune system of an Rh-negative mother produces antibodies to an antigen in the blood of an Rh-positive fetus which cross the placenta and destroy fetal erythrocytes and that is characterized by an increase in circulating erythroblasts [merriam-webster.com]

  When the condition is moderate or severe, many erythroblasts are present in fetal blood, hence, the name, erythroblastosis fetalis. [biology-online.org]

  A condition characterized by the abnormal presence of erythroblasts in the circulation of the fetus or newborns. [icd9data.com]

  National Library of Medicine (0.00 / 0 votes) Rate this definition: Erythroblastosis, Fetal A condition characterized by the abnormal presence of ERYTHROBLASTS in the circulation of the FETUS or NEWBORNS. [definitions.net]

  […] immature cells (erythroblasts) Preventing Erythroblastosis Fetalis RhoGram is admininstered to Rh- mothers at delivery. RhoGam prevents formation of Anti-Rh antibody in mother's bloodstream. [quizlet.com]

• Neutrophilia

  However, neutrophilia can be observed after intrauterine transfusion because of an increase in circulating cytokines (granulocyte-macrophage colony-stimulating factor). [emedicine.medscape.com]

To present intensive intrauterine treatment of recurrent early onset fetal erythroblastosis due to anti-M alloimmunization. A 33-year-old woman, gravid 3, para 1, had anti-M IgG antibody, which caused alloimmunization of her previous pregnancies. [ncbi.nlm.nih.gov]

7, 8 In the neonatal period, IVIG has been used for the treatment of alloimmune thrombocytopenia, 9 as an additional treatment in neonatal infections, 10 and in the rare cases of neonatal Kawasaki disease. 11 As a progression from its use for the treatment [doi.org]

The only treatment for mirror syndrome is immediate delivery of the baby How do you treat hydrops fetalis? Treatment for hydrops depends on the determined cause, if any. [chw.org]

Abstract The prognosis of erythroblastosis fetalis has been studied in relation to maternal history, maternal titer of Rh antibody, and length of fetal gestation. [pediatrics.aappublications.org]

It is important to remember the complication of hydrops has a poor prognosis of survival except for those cases that have a definite cause with established fetal treatment. What is my baby's long-term prognosis? Long-term prognosis is guarded. [chw.org]

Erythroblastosis Fetalis Prognosis The prognosis of erythroblastosis fetalis varies widely. Death may occur even before or after birth. But for most cases treatment is successful and babies do not develop life threatening complications. [howshealth.com]

(MCA) Doppler time average mean velocity (TAMV): may occur before precipitation of fetal hydrops 1 increase in fetal middle cerebral arterial (MCA) Doppler peak systolic velocity (PSV): may occur before precipitation of fetal hydrops 2 Treatment and prognosis [radiopaedia.org]

In the past two and a half years spectrophotometric examination of amniotic fluid has allowed a more accurate prognosis of degree of disease in the fetus,. .. Funding and Disclosures We are indebted to Dr. [nejm.org]

Definition / general Nucleated fetal red blood cells (nRBCs) are common in preterm placentas but are an abnormal finding in placentas at term Etiology nRBCs reflect a response to fetal hypoxia or anemia due to a variety of causes including uteroplacental [pathologyoutlines.com]

Etiology, pathogenesis Pre-requisite of Rh isoimmunization: Rh- mother and Rh+ fetus. The mother is sensitized to Rh antigen by Rh+ fetal erythrocytes that reach the maternal circulation. [atlases.muni.cz]

Olaniyan and Kevin Aghatise, Evaluation of Some Etiological Factors of Haemolytic Disease of the New Born in Ile-Ife, Open Journal of Clinical Diagnostics, 04, 01, (5), (2014). [doi.org]

Etiology/Pathophysiology: Caused by blood group incompatibilities between fetal and maternal erythrocytes. The mother has been previously exposed to heterotypic fetal erythrocytes and developed antibodies to them. [virtualpediatrichospital.org]

Etiology and Pathophysiology Alloimmunization occurs when maternal blood is exposed to an antigen that is not present on her RBCs; can occur with as little as 1 )[ C ] Can occur during RBC transfusion or fetomaternal bleeding (abortion, ectopic pregnancy [unboundmedicine.com]

Summary Epidemiology The incidence has been estimated at 1/800 to 1/1 000 live births. Clinical description NAIT has been considered to be the platelet counterpart of Rh Haemolytic Disease of the Newborn (RHD). [orpha.net]

System(s) affected: cardiovascular, hematologic, lymphatic, immunologic, nervous Synonym(s): erythroblastosis neonatorum; hemolytic disease of the fetus and newborn (HDFN); congenital anemia of the newborn; immune hydrops fetalis Epidemiology Predominant [unboundmedicine.com]

Epidemiology The incidence of haemolytic disease of the newborn (HDN) depends on the proportion of the population who are RhD negative. [patient.info]

History / Epidemiology In 1609, a French midwife first described HDN, in a set of twins—one baby was markedly edematous and died soon after birth, the second baby developed jaundice and died several days later [ 1 ]. [omicsonline.org]

Epidemiology of Rh hemolytic disease of the newborn in the United States. JAMA. 1991 Jun 26. 265(24):3270-4. [Medline]. Eder AF. Update on HDFN: new information on long-standing controversies. Immunohematol. 2006. 22(4):188-95. [Medline]. [emedicine.medscape.com]

The clinical consequences of HTRs are triggered via several pathophysiological pathways like formation of anaphylatoxins, release of cytokines causing a systemic inflammatory response syndrome, activation of the kinin system, the intrinsic clotting cascade [doi.org]

Etiology/Pathophysiology: Caused by blood group incompatibilities between fetal and maternal erythrocytes. The mother has been previously exposed to heterotypic fetal erythrocytes and developed antibodies to them. [virtualpediatrichospital.org]

It includes a review of historical perspective, pathophysiology of RBC antigen iso-sensitization, hydrops fetalis, clinical presentation, and management of HDN. [omicsonline.org]

Etiology and Pathophysiology Alloimmunization occurs when maternal blood is exposed to an antigen that is not present on her RBCs; can occur with as little as 1 )[ C ] Can occur during RBC transfusion or fetomaternal bleeding (abortion, ectopic pregnancy [unboundmedicine.com]

Acute hemolytic transfusion reaction, a paradigm of the systemic inflammatory response: new insights into pathophysiology and treatment. Transfusion. 1995 Jun. 35(6):513-20. [Medline]. Davenport RD. [emedicine.medscape.com]

Erythroblastosis Fetalis Prevention Erythroblastosis Fetalis is very preventable. Erythroblastosis Fetalis prevention is easy. Today, nearly all women with Rh-negative blood are identified in early pregnancy through blood tests. [healthncare.info]

This treatment usually prevents hemolytic disease of the newborn from developing. [merckmanuals.com]

There is a very effective preventive program of Rh-isoimmunization. Intravenous drug abuse in young women has been reported as the most common cause of Rh isoimmunization today. [atlases.muni.cz]

Prevention- Rh immune globulin 14. • Rh immune globulin contains antibodies to the Rh factor in blood.• The antibodies come from mother’s blood stream had been sensitized to Rh factor.• Giving these Rh antibodies to an Rh-Negative pregnant woman prevent [de.slideshare.net]

1. Liley AW. Liquor amnii analysis in management of pregnancy complicated by rhesus immunization. Am J Obstet Gynecol. 1961;82:1359-1371.
2. Romano EL, Hughes-Jones NC, Mollison PL. Direct antiglobulin reaction in ABO-haemolytic disease of the newborn. Br Med J. 1973;1(852):524-526.
3. Pirelli KJ, Pietz BC, Johnson ST, et al. Molecular determination of RHD zygosity: predicting risk of hemolytic disease of the fetus and newborn related to anti-D. Prenat Diagn. 2010;30(12-13):1207-1212.
4. Bianchi DW, Avent ND, Costa JM, et al. Noninvasive prenatal diagnosis of fetal Rhesus D: ready for Prime(r) Time. Obstet Gynecol. 2005;106(4):841-844.
5. Rouillac-Le Sciellour C, Puillandre P, Gillot R, et al. Large-scale pre-diagnosis study of fetal RHD genotyping by PCR on plasma DNA from RhD-negative pregnant women. Mol Diagn. 2004;8(1):23-31.
6. Murray NA, Roberts IA. Haemolytic disease of the newborn. Arch Dis Child Fetal Neonatal Ed. 2007;92(2):F83-F88.
7. Vidnes J, Finne H. Immunoreactive insulin in amniotic fluid from Rh-immunized women. Biol Neonate. 1977;31(1-2):1-6.
8. Lozar-Krivec J, Bratanic B, Paro-Panjan D. The role of carboxyhemoglobin measured with CO-oximetry in the detection of hemolysis in newborns with ABO alloimmunization. J Matern Fetal Neonatal Med. 2016;29(3):452-456.