How is hemolytic disease due to maternal-fetal blood group incompatibility treated?

Hemolytic disease of the mother and fetus usually occurs when the blood types of the mother and fetus are incompatible, most commonly due to Rh factor incompatibility or ABO blood group system incompatibility. The main treatment methods include:

1. Prenatal treatment: For ABO hemolytic disease, the pregnant woman may take phenobarbital orally two weeks before the expected delivery date to enhance the activity of fetal hepatic UDP-glucuronosyltransferase and promote bilirubin metabolism. For Rh hemolytic disease, if antibody titers are high or other high-risk factors exist, plasmapheresis or early delivery may be considered.

2. Intrapartum management: Natural delivery is preferred, avoiding the use of sedatives and anesthetics to prevent increasing the risk of fetal asphyxia. The umbilical cord should be clamped immediately after delivery to reduce the amount of antibodies entering the newborn's circulation, and preparations should be made for neonatal resuscitation.

3. Neonatal treatment: Includes phototherapy, exchange transfusion, and drug therapy. Phototherapy uses specific wavelengths of light to isomerize bilirubin, enhancing its water solubility and facilitating excretion. Exchange transfusion is suitable for severely affected infants, replacing the infant's blood containing high levels of bilirubin with fresh blood. Drug therapy, such as corticosteroids and albumin, can also be used to reduce serum bilirubin concentrations.