Last reviewed: April 2019
Last updated: November  2018

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors

Risk factors

  • maternal RhD-negative status
  • fetomaternal haemorrhage
  • invasive fetal procedures
  • placental trauma
  • abortion
  • multiparity
  • omission of Rh immunoprophylaxis
  • external cephalic version
  • molar pregnancy
  • ectopic pregnancy

Diagnostic investigations

1st investigations to order

  • maternal blood type
  • maternal serum Rh antibody screen
Full details

Investigations to consider

  • maternal serum antibody titre
  • paternal blood type
  • paternal zygosity
  • fetal ultrasound
  • Doppler velocimetry of fetal middle cerebral artery (peak systolic velocity)
  • fetal blood typing (from amniocentesis or maternal circulation)
  • direct assessment of fetal anaemia
  • rosette test
  • Kleihauer-Betke test/flow cytometry
Full details

Treatment algorithm

Contributors

Authors VIEW ALL

Associate Professor

Department of OB/GYN

Division of Maternal-Fetal Medicine

The Ottawa Hospital

University of Ottawa

Ottawa

Canada

Disclosures

KFKF is an author of a reference cited in this topic. KFKF declares that she has no competing interests.

Program Director

Maternal-Fetal Medicine Fellowship

Associate Professor

Department of OB/GYN

Division of Maternal-Fetal Medicine

The Ottawa Hospital

University of Ottawa

Ottawa

Canada

Disclosures

FM declares that he has no competing interests.

Peer reviewers VIEW ALL

Honorary Professor of Medicine

University of Glasgow

Glasgow

UK

Disclosures

AC is an author of several references cited in this monograph.

Consultant Hematologist

Bradford Teaching Hospitals NHS Trust

Yorkshire Clinic

Bingley

Bradford

UK

Disclosures

LAP declares that he has no competing interests.

Professor of Obstetrics and Gynecology

Texas Children's Fetal Center

Baylor College of Medicine/Texas Children's Hospital

Houston

TX

Disclosures

KJM declares that he has no competing interests.

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