Rh incompatibility

Rhesus (Rh) incompatibility is a condition where an Rh-negative mother carrying an Rh-positive fetus can produce antibodies against paternally derived Rh antigens on fetal red blood cells. These antibodies can cross the placenta, and destroy fetal red blood cells. It is a leading cause of hemolytic disease of the fetus and newborn, also known as erythroblastosis fetalis.

Effective immunoprophylaxis of Rh-negative at-risk mothers is key to primary prevention.

Intrauterine fetal transfusion is a lifesaving treatment for severely affected fetuses.

Survival rates are more than 90%.

Rh incompatibility occurs in an Rh-negative mother carrying an Rh-positive fetus. If the mother is exposed to the paternally derived Rh antigens on fetal red blood cells (RBCs) she can become sensitized and produce immunoglobulin G (IgG) antibodies, usually against the RhD antigen. These maternally derived antibodies can then freely cross the placenta, binding to and destroying fetal RBCs. This is a leading cause of hemolytic disease of the fetus and newborn (HDN or HDFN, also known as erythroblastosis fetalis), which involves progressive fetal anemia, and, if untreated, may ultimately lead to hydrops fetalis (collection of fluid in serous compartments) and death.[1]Hadley AG. In vitro assays to predict the severity of hemolytic disease of the newborn. Transfus Med Rev. 1995 Oct;9(4):302-13. http://www.ncbi.nlm.nih.gov/pubmed/8541713?tool=bestpractice.com ​​[2]Brennand J, Cameron A. Fetal anaemia: diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2008 Feb;22(1):15-29. http://www.ncbi.nlm.nih.gov/pubmed/17904904?tool=bestpractice.com