The outcome of babies of mothers with severe rhesus incompatibility treated at Tygerberg Hospital, 1980-1993 (original) (raw)

Rhesus Negative Mother and Perinatal Outcome

Scholars International Journal of Obstetrics and Gynecology

Background: Rhesus incompatibility is a preventable cause for severe neonatal hyperbilirubinemia, hydrops fetalis and still births. The prevalence of the Rh-negative blood group among Indian woman varies from 2%-5%. Despite declining the incidence of Rhesus incompatibility, due to availability of anti-D immunoglobulin, and improved antenatal care of the Rh-negative pregnant woman, it still accounts for a significant proportion of neonatal hyperbilirubinemia and morbidity. Objectives: To study the perinatal outcome in Rhesus negative Pregnancies. Methodology: This prospective observational study was conducted in a tertiary hospital. Women with Rh Negative Blood group admitted for delivery were enrolled. Baby's Blood Group, Birth weight, TSB levels, duration of phototherapy or exchange transfusion, duration of NICU admission, and other investigations were recorded in a predesigned, pretested proforma. Conclusion: Over the 20th century, Rh isoimmunization was clinically recognized, its pathophysiology was understood, its treatment was established, and preventive measures were created to eliminate it. Awareness should be increased amongst health care providers regarding RAADP and prophylaxis after MTP, abortion, ectopic pregnancy in Rh negative blood group, and importance of Antenatal Care and importance of Rh typing in pregnancy.

Pregnancy outcome for Rh-alloimmunized women

2005

Objective: To compare perinatal results of Rh-alloimmunized pregnancies managed with spectrophotometric amniotic fluid analysis or fetal middle cerebral artery Doppler ultrasonographic velocimetry. Method: A descriptive observational study involving 291 consecutive Rh-negative pregnancies. Group 1 consisted of 74 isoimmunized women managed with amniotic fluid spectrophotometry; group 2 of 25 isoimmunized women managed with Doppler ultrasonography; and group 3 of 192 nonimmunized Rh-negative women. The variables analyzed were need for intrauterine or neonatal transfusion, mode and time of delivery, birth weight, neonatal hematocrit, and perinatal mortality. Results: Need for intrauterine transfusion, birth weight, prematurity, rate of cesarean section, and perinatal mortality were similar in groups 1 and 2. Neonatal hematocrit was significantly lower and the need for neonatal transfusion was significantly higher when spectrophotometry rather than Doppler ultrasonographic velocimetry was used. Conclusion: Fetuses managed with Doppler ultrasonographic velocimetry had a higher hematocrit at birth and a lesser need for neonatal transfusion, suggesting that this noninvasive method of monitoring fetal anemia is a better choice.

Effect and Association of ABO & Rh Incompatibility on Maternal Outcome

https://www.ijhsr.org/IJHSR\_Vol.7\_Issue.10\_Oct2017/IJHSR\_Abstract.07.html, 2017

Background: Incompatibility affects those pregnancies in which maternal antibodies when cross the placental barrier and enters the fetal circulation, reacts and damage the fetal red cells, thus causing their premature destruction and results into HDN, Hydrops and even still birth. Objective: To find the effect and association of incompatibility on maternal outcome. Material and Methods: This was a prospective, observational study performed on 550 couples having female partners of 18 to 50 yrs. of age. ABO and Rh grouping was performed and compatibility was detected within each couple. The maternal record of couples was observed for fertility, reproductive outcome, live birth status, history of HDN and mortality of infants. Results: The overall distribution of ABO & Rh among the compatible and incompatible group was not significantly different. Fertility, reproductive outcome, gender wise child birth and infant mortality were found independent with compatibility (p>0.050) but significant association was found with HDN (p=0.005), with gender of infant mortality (p=0.001). Compatible mating types were also found associated with gender of child birth and HDN (p<0.050). Conclusion: It was concluded that incompatibility has no qualitative effect on the fertility, reproductive outcome and on infant mortality except HDN. But on the other hand, different mating types were found associated with gender of the born child, HDN and in some cases gender of the deceased infant. The data generated in this study will be useful for anticipatory management of the manifestations of incompatibility.

Early Intrauterine Transfusion in Rh sensitized wom en

2010

A 25 year G P NND A case of severe Rh isoimmunisation was referred at 14.2 weeks 6 4 4 1 for poor obstetrical outcome. Serial colour Doppler studies were done to assess the foetal well being by measuring the MCA-PSV values and accordingly the intrauterine transfusions were done, the earliest at 15.5 weeks of gestation. Total of 6 intrauterine transfusions were planned over 33 weeks, 2.2 kg baby delivered at 33.2 weeks with uneventful perinatal period requiring no exchange transfusion. Thus prophylactic intrauterine transfusion without waiting for development of signs and symptoms of hydrops can change the outcome in severely Rh sensitized pregnancies.

Severe hemolytic disease of the premature newborn due to RH1 incompatibility: a case report

Clujul Medical, 2016

We report a case of dramatic outcome of severe haemolytic disease in a newborn due to RH1 incompatibility. A newborn with A RH1 blood group was admitted in the Mohammed V Military Teaching Hospital for the problem of hydrops fetalis associated with RH1 incompatibility. The blood group of his mother, aged 31, was AB RH1-negative and that of his 37 year old father was A RH1.The mother had a history of 4 term deliveries, 3 abortions, and 1 living child. There was no prevention by anti-D immunoglobulin postpartum. The mother‘s irregular agglutinin test was positive and the pregnancy was poorly monitored. The laboratory tests of the newborn showed a high total serum bilirubin level (30 mg/L) and macrocytic regenerative anemia (Hemoglobin=4 g/dL, mean corpuscular volume = 183 fL, reticulocytes count =176600/m3). The blood smear showed 1256 erythroblasts per 100 leukocytes, Howell–Jolly bodies and many macrocytes. The direct antiglobulin test was positive. He was transfused with red blood ...

Management of Rhesus Isoimmunized Pregnant Woman in Low Resource Setting: A Case Report

2021

Rh isoimmunization of pregnant mothers may be responsible for varying severity of anaemia in fetuses and newborns. Usually, it is in the second or subsequent pregnancies that the fetus is affected. Management of this patient in a low resource setting posed serious challenges as various interventions levels. A 28-year-old G6P5+0 1alive at 17weeks of gestation, in her six pregnancy who had developed Anti-D antibodies after her first pregnancy. pregnancy was unbooked, carried to term and had spontaneous vaginal delivery at home to a live female neonate. She was unaware of her blood group and Rhesus typing and did not received Anti-D immunoglobulin. Subsequently, she had recurrent intrauterine stillbirth and early neonatal death. Current pregnancy was carried to 31weeks of gestation when it was noticed the fetus had severe anaemia following evaluation with middle cerebral artery-peak systolic velocity and had Caeserean section. The neonate had exchange blood transfusion and phototherapy...

Treatment of fetal anemia in Rh isoimmunized pregnancies with intrauterine fetal blood transfusion

The Journal of Obstetrics and Gynecology of India, 2010

The discovery of Rhesus factor by Landsteiner in 1940 1 and the association of 'hydrops fetalis' with erythroblastosis fetalis led to the understanding of the pathogenesis and the complications of Rh sensitization. This is fetal / neonatal hemolytic disease leading to neonatal jaundice in the mild cases, to kernicterus and cerebral palsy, neonatal death, need for exchange transfusions, hydrops fetalis and finally intrauterine death in the severe cases. Prognosis in subsequent pregnancy is considered worse as fetal anemia sets in 8-10 weeks earlier than in previous pregnancy. Introduction and utilization of Rh D immunoglobulin 135