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Incompatibilidad Rh

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Evidence last reviewed: 24 Sep 2026
Topic last updated: 13 May 2026

Summary

Definition

History and exam

Key diagnostic factors

  • presencia de factores de riesgo
Full details

Risk factors

  • antecedentes de un feto rhesus D (RhD) positivo en una madre RhD negativa
  • hemorragia fetomaterna
  • procedimientos fetales invasivos
  • traumatismo placentario
  • aborto
  • multiparidad
  • omisión de la inmunoprofilaxis contra el factor rhesus D (RhD)
  • versión cefálica externa
  • embarazo molar
  • embarazo ectópico
Full details

Diagnostic tests

1st tests to order

  • grupo sanguíneo materno
  • prueba de cribado de anticuerpos en suero materno
Full details

Tests to consider

  • título de anticuerpos séricos maternos
  • grupo sanguíneo paterno
  • cigosis paterna
  • ultrasonido fetal
  • Velocimetría Doppler de la arteria cerebral media fetal (velocidad sistólica pico)
  • determinación del grupo sanguíneo fetal (por amniocentesis o circulación maternal)
  • evaluación directa de la anemia fetal
  • prueba de rosetas
  • prueba de Kleihauer-Betke/citometría de flujo
Full details

Treatment algorithm

INITIAL

madre RhD negativa no sensibilizada

madre RhD negativa sensibilizada

ACUTE

recién nacido con enfermedad hemolítica del recién nacido

Contributors

Authors

Andrea Shields, MD

Associate Professor of Obstetrics and Gynecology

Program Director Maternal Fetal Medicine Fellowship

Division of Maternal Fetal Medicine

University of Connecticut School of Medicine

Farmington, CT

Disclosures

AS declares that she has no competing interests.

Kristen Elmezzi, DO

Maternal Fetal Medicine Fellow

Division of Maternal Fetal Medicine

University of Connecticut School of Medicine

Farmington, CT

Divulgaciones

KE declares that she has no competing interests.

Agradecimientos

Dr Andrea D. Shields and Dr Kristen Elmezzi would like to gratefully acknowledge Dr Andrew D. Hull, Dr Karen Fung-Kee-Fung, and Dr Felipe Moretti, previous contributors to this topic.

Divulgaciones

KFKF is an author of a reference cited in this topic. ADH, KFKF, and FM declare that they have no competing interests.

Revisores por pares

Alan Cameron, MD

Honorary Professor of Medicine

University of Glasgow

Glasgow

UK

Divulgaciones

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

Liakat Ali Parapia, MD, FRCP

Consultant Hematologist

Bradford Teaching Hospitals NHS Trust

Yorkshire Clinic

Bingley

Bradford

UK

Divulgaciones

LAP declares that he has no competing interests.

Kenneth J. Moise, Jr., MD

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Obstetrics and Gynecology. ACOG practice bulletin no. 181: prevention of Rh D alloimmunization. Obstet Gynecol. 2017 Aug;130(2):e57-70. Abstract

Brennand J, Cameron A. Fetal anaemia: diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2008 Feb;22(1):15-29. Abstract

Visser GHA, Thommesen T, Di Renzo GC, et al. FIGO/ICM guidelines for preventing Rhesus disease: a call to action. Int J Gynaecol Obstet. 2021 Feb;152(2):144-7.Full text  Abstract

American Congress of Obstetrics and Gynecology. ACOG practice bulletin no. 192: management of alloimmunization during pregnancy. Obstet Gynecol. 2018 Mar;131(3):e82-90. Abstract

Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. Transfus Med. 2014 Feb;24(1):8-20.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Incompatibilidad Rh images

  • Differentials

    • Hidropesía fetal no inmune
    • Infección por parvovirus
    • Enfermedad hemolítica no RhD
    More Differentials

  • Diretrizes

    • Ectopic pregnancy and miscarriage: diagnosis and initial management
    • Guideline for the investigation and management of red cell antibodies in pregnancy
    More Diretrizes
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