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Haemolytic Disease of the Newborn (HDN) is a condition in which maternal antibodies cross the placenta and destroy the baby’s red blood cells. It commonly develops when there is an incompatibility between maternal and fetal blood groups, particularly Rh(D) incompatibility. ABO incompatibility can also cause disease, although it is often milder.

The destruction of red blood cells may lead to anaemia and increased bilirubin production. After birth, affected newborns can develop jaundice, pallor, poor feeding, lethargy, rapid breathing, or an enlarged liver and spleen. In severe cases, excessive bilirubin can enter the brain and cause kernicterus, resulting in permanent neurological damage.

Diagnosis may involve maternal blood-group testing, antibody screening, fetal monitoring, and examination of the newborn’s blood. The direct antiglobulin test helps identify antibodies attached to the infant’s red blood cells. Bilirubin and haemoglobin levels are also monitored closely.

Treatment depends on severity and may include phototherapy, intravenous immunoglobulin, or blood transfusion. Severe fetal anaemia may require intrauterine transfusion before delivery. Rh(D) disease is largely preventable through appropriate anti-D immunoglobulin administration to eligible Rh-negative mothers during pregnancy and after delivery. Early recognition and careful monitoring significantly improve outcomes.