(6)
Bile-stained umbilical cord.
c. Treatment depends on the degree of maternal sensitization and the effects
of hemolytic disease on the fetus or newborn.
(1)
Intrauterine-intraperitoneal transfusion.
(a) This is performed when amniotic fluid analysis suggests the fetus
is severely affected and delivery is inappropriate due to fetal immaturity.
(b) A transabdominal puncture into the fetal peritoneal cavity allows
infusion of group O, Rh-negative blood.
(c) This may be repeated every two weeks until the fetus is mature
enough for delivery.
(2) Exchange transfusion. This removes antibody-coated RBCs and
prevents hyperbilirubinemia through removal of the infant's blood and replacement with
fresh group O, Rh-negative blood.
(3) Albumin infusion. This aids in the binding of bilirubin, reducing the
chances of hyperbilirubinemia.
d. Nursing interventions.
(1)
Reassure parents, explain procedures, and allow them time to
ventilate.
(2)
Provide patient teaching.
(3)
Maintain baby's temperature.
(4)
Keep resuscitative equipment available.
(5)
Watch for complications of transfusion.
(a) Muscular twitching.
(b) Convulsions.
(c)
Dark urine.
MD0922
11-14