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hemolytic disease

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Section 1 - General principles
Edited by Mark D. Kilby, Anthony Johnson, Baylor College of Medicine, Texas, Dick Oepkes
Book:

Fetal Therapy

Published online:

05 February 2013

Print publication:

13 December 2012, pp -
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Summary

Initial therapies such as intrauterine transfusion for severe hemolytic disease of the fetus were undertaken based on sound physiological principles and an understanding of the basic pathogenesis but were never subjected to randomized clinical trials. More recent targeted interventions for such conditions as treatment for severe twin-to-twin transfusion syndrome (TTTS), myelomeningocele (MMC) and congenital diaphragm hernia (CDH) have been the subject of well-designed randomized investigations. This chapter elucidates the history and the basis for the treatment of these fetal interventions. Routine induction of labor at a premature gestation was the only therapy that could be offered to attempt to curb the inevitable death due to hemolytic disease of the fetus and newborn (HDFN) that occurred in 30% of cases. The human fetus has indeed become a patient and development of treatments is a work in progress.