After delivery

• Full paediatric support—metabolic, nutritional and respiratory.

• If unconjugated hyperbilirubinaemia not a problem, treat anaemia (note: cord blood Hb <14.0g/dL) by simple transfusion.

• Exchange transfusion with Rh (D) neg and (if possible) group specific blood for:

- A severely affected hydropic anaemic baby.

- Hyperbilirubinaemia (bilirubin level at or near 340mmol/L (20mg/dL) or rapidly rising level e.g. >20mmol/h) in first few days of life.

- Signs suggesting kernicterus—exchange transfusion may have to be repeated.

• Phototherapy to reduce the bilirubin level.

• Follow-up required—late anaemia can be severe particularly if exchange transfusion has not been carried out.

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