Hemolytic Disease of the Fetus and Newborn due to Rh Incompatibility

Abstract

Introduction: Hemolytic disease of the fetus and newborn due to Rh incompatibility is a hemolytic disease that can cause severe anaemia due to the formation of anti-Rh D-positive antibodies in a Rh-negative pregnant woman. Administration of anti-D immunoglobulin reduces the risk of alloimmunization. Objective: To determine the most appropriate management in Rh-negative pregnant women to prevent maternal perinatal alloimmunization. Methodology: The clinical question, formulated in accordance with the PICO format, enabled a targeted and efficient information search. What is the recommended course of action for the management of Rh-negative pregnant women to prevent maternal-fetal alloimmunization? The search for scientific information was conducted in the following biomedical databases: DynaMed, UpToDate, PubMed and Web of Science. Results: A total of 730 articles were identified. Following the application of filters, the removal of duplicate articles and the exclusion of articles not meeting the inclusion criteria, 33 articles were selected as sources of information for this research project. Discussion: It is important to note that if an individual with negative Rh status is sensitized, they will form anti-Rh D positive antibodies throughout their lifetime. This can potentially place their Rh D positive blood group children at risk. It is therefore vital to administer anti-D immunoglobulins in order to prevent alloimmunization during an event where there is a
risk of alloimmunization. Conclusions: It is important to note that alloimmunization can be a serious complication. However, this can be prevented with the administration of anti-D immunoglobulins, ideally within the first 72 hours of a sensitizing event.