In recent decades, there have been numerous new treatment options for hemolytic disease of the fetus and newborn (HDFN) that have helped improve outcomes for infants, according to a study recently published in Transfusion Medicine Reviews.
One of the most commonly used preventative measures in HDFN is the administration of Rhesus immunoglobulin in Rhesus D-negative women who have a history of pregnancy with a Rhesus D-positive child. Studies show that the administration of Rhesus immunoglobulin can reduce the incidence of HDFN by 85%, making it a life-saving treatment for some women.
In addition, giving women who need blood transfusions blood products that are matched with their red blood cell (RBC) antigens can reduce the risk of alloimmunization that can cause HDFN during pregnancy. However, the extent to which RBC antigen matching is feasible is debatable, given that this requires detailed screening for every patient.
Read more about HDFN testing and diagnosis
Intravenous immunoglobulin remains one of the most commonly administered treatments in pregnancies affected by HDFN. Studies indicate that this treatment can reduce fetal mortality by 36%.
Intrauterine blood transfusions, which are blood transfusions to the fetus while in the womb, remain a therapeutic option that can yield potent results. However, this is an invasive procedure that is typically administered via the umbilical vein of the fetus. Doctors typically carefully assessed eligibility before administering this therapy.
After delivery, newborns affected by HDFN are typically administered intensive phototherapy, which is effective in reducing high bilirubin levels that arise from the breakdown of red blood cells. If necessary, doctors can also perform exchange transfusions, which is used in approximately a fifth of HDFN cases caused by Rhesus D incompatibility.
Unfortunately, access to HDFN therapies are limited in some parts of the globe. Therapies such as plasma derivatives require both human donors and the infrastructure to process and store these blood products. HDFN care thus remains representative of global inequalities.
“Concurrent with the efforts of developed economies to share resources beyond their borders, we dare to imagine that healthcare professionals in resource-limited economies will share their prevention and treatment innovations with a broader audience,” the authors of the study wrote.
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