[Rhesus erythroblastosis, monitoring and treatment]

From 1975-1984 92 pregnancies with suspicion of a morbus hemolyticus fetalis were monitored at the University Hospital of Freiburg, Department of Obstetrics and Gynecology. Most of the patients had antibodies against the rhesusfactor D. Amniocentesis was carried out regularly; the bilirubin level and protein content of the amniotic fluid were measured using chemical methods and the bilirubin/protein ratio was determined. The results obtained correlated well with the values of spectrophotometrically measured bilirubin, which reliably indicated the severity of the hemolytic disease. A serious erythroblastosis was observed in 17 cases. Four children died before any treatment was initiated. In 13 children 37 intrauterine transfusions (IUT) were performed. The survival rate of the children with IUT's was 69%, in nonhydropic children it was 82%. The mortality risk of the IUT was low. Children with IUT's often showed complications in the perinatal period, which were due to the premature birth and the erythroblastosis.