Final answer:
In a fetus suffering from Rh-disease due to a 24 Rh negative G2P1 mother with anti-D antibodies, the expected ultrasound findings include fetal hydrops and hepatosplenomegaly, as the Rh antibodies attack fetal red blood cells. This condition usually arises in subsequent pregnancies when prophylactic treatment with RhoGAM is not administered after the first Rh-positive pregnancy.
Step-by-step explanation:
If a 24 Rh negative G2P1 is found at 10 weeks gestation to have anti-D antibodies and subsequently presents with a fetus suffering from Rh-disease, several findings may be expected on serial fetal ultrasound (U/S). Rh-disease can lead to erythroblastosis fetalis, a condition where the mother's Rh antibodies attack the fetal red blood cells, causing agglutination and hemolysis.
On ultrasound, this may manifest as fetal hydrops which is an abnormal collection of fluid in at least two fetal body compartments, including ascites, pericardial effusion, pleural effusion, and skin edema. It can also result in hepatosplenomegaly, where the liver and spleen are enlarged as they attempt to produce more red blood cells to compensate for the ones being destroyed.
The risk of Rh-disease arises because during the birth of a first Rh-positive child, the mother may produce primary anti-Rh antibodies. If she does not receive prophylactic treatment with RhoGAM and has a subsequent Rh-positive pregnancy, the existing IgG anti-Rh antibodies can readily cross the placenta and attack the fetal red blood cells, causing anemia and potentially leading to hydrops fetalis. RoGAM is a preventative treatment given during pregnancy and after delivery, which significantly reduces the risk of Rh-disease in subsequent pregnancies.