The page below is a sample from the LabCE course Hemolytic Disease of the Fetus and Newborn. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

Learn more about Hemolytic Disease of the Fetus and Newborn (online CE course) »
How to Subscribe
MLS & MLT Comprehensive CE Package
Includes 94 CE courses, most popular
$95 Add to cart
Pick Your Courses
Up to 8 CE hours
$50 Add to cart
Individual course$20 Add to cart

Postnatal Treatment: Exchange Transfusion

A hallmark of HDFN treatment is to induce labor as early as possible once lung maturity has been attained so that the newborn will be able to survive.

Once the infant is born, the main treatment for severe HDFN due to anti-D (and other antibodies causing severe disease) is exchange transfusion.

In exchange transfusions, up to 85–90% of the infant's blood can be exchanged with donor blood by a process of removing 5–20 mL of blood at a time, and injecting an equivalent amount until the exchange is complete.

An exchange transfusion accomplishes the following:

  1. Removes bilirubin and thus helps prevent kernicterus
  2. Removes sensitized red cells that have not been broken down yet
  3. Removes circulating maternal antibody
  4. Provides antigen-negative red cells that will not be destroyed by the maternal antibody, thus will survive and provide oxygen to the tissues.