Proper prenatal care and hemolytic disease of the fetus and newborn (HDFN) prophylaxis through Rh immunoglobulin (RHIG) administration can successfully prevent complications in Rh-negative pregnancies, as shown by a recently published study in the Indian Journal of Obstetrics and Gynaecology.
Pregnancies in which the mother is Rh negative, meaning that she does not carry the RhD antigen on their surface, are at risk of HDFN-associated complications. If the mother has had a previous pregnancy or has received blood transfusions with RhD-positive blood, there is a high possibility that she is alloimmunized.
Alloimmunization is a medical term for producing antibodies targeting the RhD antigen. These antibodies can cross the placenta and enter fetal circulation, producing HDFN.
Learn more about HDFN testing and diagnosis
“The prevalence of Rh isoimmunization complicating pregnancy is <1% worldwide. The most common fetal complications in Rh-sensitized pregnancy include hemolytic disease of the fetus and newborn (HDFN), fetal or neonatal anemia, kernicterus and early miscarriage due to hydropic changes (hydrops fetalis),” the authors wrote.
Therefore, testing to detect Rh incompatibility is of the utmost importance in prenatal care. The administration of the RHIG has successfully prevented HDFN complications for decades in alloimmunized pregnancies.
The authors aimed to test the outcomes of Rh-negative pregnancies in eastern India to assess the status of prenatal care in this region.
The study included data from over 1800 pregnancies during one year, of which 52 were Rh-negative, representing approximately 2% of the sample. Approximately half of the Rh-negative patients were in their first pregnancy.
Results showed that none of the Rh-negative mothers were alloimmunized. RHIG was administered appropriately in all cases.
Regarding the outcomes, the authors observed that only nine of the Rh pregnancies resulted in preterm delivery. Approximately 27% of the babies born of Rh-negative mothers had low weight at birth.
There were complications in eight pregnancies not necessarily associated with Rh status, namely eight cases of preeclampsia, one polyhydramnios, and three abruptio placentae.
“ By thorough screening in pregnancy and timely proper interventions, sensitization can be prevented along with the subsequent development of complications following it.” the authors concluded.
