In the past 40 years, tremendous advances in the treatment of hemolytic disease have been made. The
perinatal mortality has been reduced considerably. Rh immunoprophylaxis has decreased the incidence of Rh
immunization to around 6 per 100,000 live births. Nevertheless, treatment of severe hemolytic disease is still
essential. Increased reliability of diagnostic procedures have made early detection and optimal treatment of hemolytic
disease possible. Treatment by plasmapheresis is still controversial. Although believed to be beneficial by some
authors, conclusive evidence of its efficacy has not been obtained. With preterm induction of birth at 32 weeks of
gestation, the chances for survival are 95%. Improvement of techniques and the use of modern real-time ultrasound
equipment have made intrauterine intraperitoneal transfusion, in experienced hands, a relatively safe and successful
procedure. Intravascular transfusion appears beneficial in early pregnancy. Combination of both techniques will
probably be the answer for the future. The development of neonatal intensive care facilities has made a major
contribution to the survival of children with haemolytic disease. The relative low incidence of haemolytic disease has
made it imperative that treatment should take place in centers where experience and special skill are available.