Hemolytic disease of the fetus and newborn (HDFN), a pregnancy complication that can lead to severe complications if left untreated, is often treated with Rhesus immunoglobulin as a therapeutic solution.
While highly effective most of the time, the fact is that this treatment cannot prevent all cases of HDFN. Read on to find out why this is the case.
Right treatment, wrong time
Rhesus immunoglobulin, like all therapies, are most effective when administered within certain windows. If you are under the care of an experienced OB/GYN, you typically need not worry about the treatment being administered at a time of poor efficacy.
Rhesus immunoglobulin is typically administered to Rhesus-negative pregnant women at approximately 28 weeks of gestation. It is also typically administered within 72 hours after delivery or when what is called a “sensitizing event” occurs, which may include a miscarriage, an ectopic pregnancy, or an invasive diagnostic procedure known as amniocentesis. It is crucial that this therapy is administered prior to sensitization for it to work effectively to prevent antibody production.
Read more about HDFN testing and diagnosis
Another way in which this treatment becomes ineffective is if the mother had a previous pregnancy associated with Rhesus-mediated HDFN. Remember that Rhesus immunoglobulin is administered to prevent sensitization; it is what is known as a prophylactic therapy, meaning that it is given to proactively prevent an undesired medical event from occurring. After sensitization has occurred, Rhesus immunoglobulin is no longer effective.
Different Types of HDFN
While Rhesus-mediated HDFN is undoubtedly one of the most common forms of HDFN, it is by no means the only one. Another common cause of HDFN is ABO blood group incompatibility.
There are also rarer forms of HDFN that receive much less attention, such as HDFN driven by Kell incompatibility. Any other form of HDFN that is not Rhesus-mediated will not benefit from Rhesus immunoglobulin.
Human Error
In very rare instances, human error in the administration of Rhesus immunoglobulin may occur. Examples of human error include administering the wrong medication or the right medication at the wrong dose. However, in hospital settings, there are plenty of checks and balances that are designed to prevent these kinds of human errors from occurring, and a mistake involving drug administration is always taken very seriously, with formal investigations likely to be launched to identify how this event happened.
Sign up here to get the latest news, perspectives, and information about HDFN sent directly to your inbox. Registration is free and only takes a minute.
