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Prevention of Maternal Rh D Alloimmunization: A Comparative Review of Guidelines.
Obstet Gynecol Surv
December 2024
Associate Professor.
Importance: Rhesus alloimmunization refers to the sensitization of an Rh D-negative mother after exposure to D-positive fetal red blood cells, which can lead to significant fetal and neonatal morbidity and mortality.
Objective: The aim of this study was to review and compare the most recently published international guidelines on the prevention of maternal alloimmunization.
Evidence Acquisition: A comparative review of guidelines from the American College of Obstetricians and Gynecologists, the British Committee for Standards in Hematology, the International Federation of Gynecology and Obstetrics, the Royal Australian and New Zealand College of Obstetricians and Gynecologists, and the Society of Obstetricians and Gynecologists of Canada regarding the prevention of maternal Rh D alloimmunization was conducted.
Anti-G evaluations in D- pregnant women determine the need for Rh immune globulin prophylaxis: report of two illustrative cases.
Immunohematology
December 2024
Department of Pathology, University of Wisconsin Hospital, Madison, WI.
Distinguishing anti-D, anti- C, and anti-G specificities is particularly essential in antenatal cases to ensure proper patient management. The clinical management as well as Rh immune globulin (RhIG) prophylaxis depend on the accurate identification of these distinct antibodies. D- pregnant women with anti-G, but without anti-D, in their serum need RhIG prophylaxis at 28 weeks of gestation, at delivery if the infant is D+, and when clinically indicated to prevent the formation of anti-D and potential hemolytic disease of the fetus and newborn (HDFN).
View Article and Find Full Text PDFHemolytic disease of the fetus and newborn and Rhesus alloimmunization in Latin American countries: a scoping review.
BMC Pregnancy Childbirth
December 2024
Immunology LATAM, Janssen, Mendoza, Buenos Aires, CP (1428), 1259, Argentina.
Background: Hemolytic disease of the fetus and newborn (HDFN) is a condition due to maternal blood group antibodies targeting antigens in fetal red blood cells, with significant prenatal/perinatal morbidity and mortality. Severe HDFN cases are often associated with alloimmunization against Rhesus D (RhD) or Kell antigens. Information about HDFN epidemiology and treatment in Latin American countries is limited.
View Article and Find Full Text PDFEvaluation of the clinical effect of a nationwide implementation of targeted routine antenatal anti-D prophylaxis in Denmark.
Transfusion
January 2025
Department of Clinical Immunology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Background: In 2010, Denmark was the first country to implement a targeted routine antenatal anti-D prophylaxis (tRAADP) program, offering fetal RHD genotyping to all nonimmunized D negative pregnant women. The program represented a shift from only postnatal prophylaxis to a combined antenatal and postnatal prophylaxis. This study aimed to evaluate the clinical effect of tRAADP in Denmark.
View Article and Find Full Text PDFShrill cry, opisthotonus, and sun setting sign in a yellow neonate.
Trop Doct
December 2024
Department of Neonatology, All India Institute of Medical Sciences - Rishikesh, Rishikesh, Uttarakhand, India.
We report a case of severe neonatal hyperbilirubinaemia (NNH) in a term neonate due to rhesus isoimmunisation resulting in classical clinical features of acute bilirubin encephalopathy and its sequel, kernicterus. Though NNH is common, its complications are less often encountered today with the widespread availability of effective phototherapy. It is important not to miss the clinical signs of this preventable cause of neuro-disability.
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