The answer used to be that unless your baby becomes very anaemic in the womb, it was quite difficult to tell if the baby's red blood cells were being destroyed by antibodies crossing the placenta from your circulation without putting a needle intop baby's umbilical cord (cordocentesis). But recently, middle cerebral artery (MCA) Doppler monitoring of the baby gives a good indication of the speed of blood flow in the baby's circulation; if the blood is flowing faster-it can mean anaemia in baby. There are other signs too: If a baby becomes moderately anaemic, he will stop moving normally, and an ultrasound may show increased fluid (waters) around the baby and fluid accumulating in the baby's tummy (ascites) and around the heart (pericardial effusion). Furthermore, a heart rate trace (CTG) may show abnormalities. At this stage, depending on how far your pregnancy has reached, the baby will either need an intra-uterine blood transfusion in a specialised fetal medicine unit or, if after about 34 weeks, then delivery may be discussed.
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