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Rh haemolytic disease — RACP Paediatrics MCQ

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ModerateNeonatalRh haemolytic diseaseRACP Paediatrics

A term neonate develops jaundice at 12 hours of age with a rapidly rising unconjugated bilirubin. The mother is Rh-negative and the baby is Rh-positive. Direct antiglobulin test (DAT) is strongly positive. Haemoglobin is 120 g/L with reticulocyte count of 15%. What is the most likely diagnosis?

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Correct answer: E — Rhesus haemolytic disease

Early-onset jaundice with a strongly positive DAT in an Rh-negative mother with an Rh-positive baby is Rhesus haemolytic disease of the newborn (HDN). The positive DAT confirms maternal anti-D antibodies coating fetal red cells. Management includes intensive phototherapy and possible exchange transfusion. IVIg may reduce the need for exchange transfusion.

Reference: RCH Melbourne – 2023 – Neonatal Haemolytic Disease CPG; RACP Paediatric Curriculum – Neonatology