Overview of Rhesus D alloimmunization in pregnancy
- Kenneth J Moise Jr, MD
Kenneth J Moise Jr, MD
- Professor of Obstetrics, Gynecology and Reproductive Sciences
- Professor of Pediatric Surgery
- University of Texas School of Medicine at Houston
Rhesus (Rh)-D negative women who deliver an Rh(D) positive baby or who are otherwise exposed to Rh(D) positive red cells are at risk of developing anti-D antibodies. Rh(D) positive fetuses/neonates of these mothers are at risk of developing hemolytic disease of the fetus and newborn (HDFN), which can be associated with serious morbidity or mortality.
Implementation of programs for antenatal and postnatal anti-D immune globulin prophylaxis has led to a significant reduction in the frequency of Rh(D) alloimmunization and associated fetal/neonatal complications. However, Rh(D) alloimmunization with serious sequelae in offspring still occurs, particularly in low resource countries where anti-D immune globulin is not widely available . Where appropriate monitoring and intervention are available, HDFN can be treated successfully in most cases.
This topic provides an overview of Rh disease in pregnancy. Prevention and management of Rh disease, as well as management of pregnancies with alloimmunization to other red cell antigens, are reviewed in detail separately.
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- THE RHESUS SYSTEM
- D, d, C, c, E, e, and G
- Prevalence of Rh(D)-negative blood type
- Rh(D) variants
- PATHOGENESIS AND CONSEQUENCES OF ALLOIMMUNIZATION
- MANAGEMENT OF PREGNANCIES COMPLICATED BY ALLOIMMUNIZATION
- NEONATAL ISSUES
- ALLOIMMUNIZATION OTHER THAN RH(D)
- SUMMARY AND RECOMMENDATIONS