Treatment and Prevention of Rh Isoimmunization

Agarwal, Krishna; Rana, Anubhuti; Ravi, A.

doi:10.1007/s40556-014-0013-z

Cited by 12 publications

(6 citation statements)

References 19 publications

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“…For example, in India, 93% population is D positive, whereas, blacks are 92% positive, and Asian and Native Americans are 99% Rh D positive. 3 More than 330 blood group antigens are known, with more than 50 documented to cause HDFN. 2 Rhesus D blood antigen is the most immunogenic, and its association with HDFN was first described by Levin and Stetson in 1939.…”

Section: Clinical Significancementioning

confidence: 99%

Rare and Multiple Alloimmunization in Antenatal Women: A Case Report

Garg,

Sharma,

Payal

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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Maternal alloimmunization is uncommon and highly variable, and general obstetricians are not familiar with, non-ABO, non-D alloimmunization. Therefore, when a woman with anti-D alloimmunization, who has received antibody prophylaxis, still develops fetal anemia in a subsequent pregnancy, it is commonly labeled as inadequate prophylaxis or a coincidental non-immune cause of fetal anemia. We report a similar case of unusual and multiple alloimmunization, where anti-D, anti-C, and anti-U antibodies were present resulting in hemolytic disease of the fetus and newborn (HDFN). The case emphasizes the need for routine and periodic antibody screening in all pregnant women, irrespective of their ABO and Rh status, which will allow monitoring from early pregnancy and timely intervention to avoid poor fetal and neonatal outcomes.

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Section: Clinical Significancementioning

confidence: 99%

Rare and Multiple Alloimmunization in Antenatal Women: A Case Report

Garg,

Sharma,

Payal

et al. 2023

Journal of South Asian Federation of Obstetrics and Gynaecology

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“…HDFN stands as a major contributor to fetal and neonatal mortality, causing over 50,000 deaths annually, particularly in developing countries across Asia and sub-Saharan Africa (Agarwal et al, 2014). For a woman to give birth to an infant with HDFN, the couple must be discordant in terms of ABO blood group and especially Rh(D) (the mother being Rh(D) negative and the father Rh(D) positive), attributed to the polymorphism of this antigen (Avent and Reid, 2000).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of blood donor women at risk of Hemolytic disease of the Fetus and Newborn in Southern Benin

2023

Int. J. Biosci.

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Hemolytic Disease of the Fetus and Newborn (HDFN) is a genetic disorder caused by blood group incompatibility, particularly Rh (D) antigen, in the parental couple. This study aimed to determine the prevalence of blood donor women exposed to the risk of HDFN among 913 blood donors in the southern region of Benin. The study was conducted from March to June 2022 at the departmental blood transfusion centers in the Atlantic and Littoral regions. Samples were collected following the procedures of the National Blood Transfusion Agency (NBTA), using tube and microplate agglutination tests. Among the donors, 260 (28.5%) were women aged between 18 and 52 years. The O+ blood group donors constituted the largest proportion, accounting for 42% of the sample. Nearly one-third (33.3%) of the female blood donors were Rh (D) negative, putting them at risk of HDFN. Most of these women were of reproductive age, with a significant representation in the 20-30 age groups (42.1%). This study revealed that one-third of female blood donors in the Atlantic and Littoral regions were at risk of giving birth to an infant affected by HDFN. These findings underscore the importance of raising awareness and implementing preventive measures to mitigate the risks associated with this condition.

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“…RhD alloimmunization in the pregnant mother may cause anemia in the fetus or newborn, and severe cases may ultimately lead to baby's demise. The most effective strategy used to reduce the incidence of RhD alloimmunization is the introduction of anti-D IgG prophylaxis [3].…”

Section: Introductionmentioning

confidence: 99%

Recombinant anti-D for prevention of maternal-foetal Rh(D) alloimmunization: a randomized multi-centre clinical trial

et al. 2020

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Objective To compare the efficacy and safety of recombinant anti-D (R-anti-D) with conventional polyclonal anti-D (Poly anti-D) in preventing maternal-fetal rhesus D (RhD) alloimmunization and to investigate the immunogenicity of R-anti-D. Methods This was a randomized, open-label, multi-center clinical trial conducted in RhD-negative pregnant women who did not receive antenatal anti-D who delivered RhD-positive babies and showed negative indirect Coombs tests (ICTs) at baseline. The women were randomized in a 2:1 ratio to R-anti-D or Poly anti-D groups and were administered 300 mcg (IM) of the corresponding drug within 72 hours of delivery. ICT was performed 72 hours, 90 days, and 180 days after anti-D injection. Serum samples were collected to check for the development of antibodies against R-anti-D at days 90 and 180, using bridging enzyme-linked immunosorbent assay. The proportion of subjects who had positive ICT results at days 90 and 180 were compared between the groups using Fisher's exact test. Results A total of 144 women were randomized to the R-anti-D group and 71 to the Poly anti-D group. Three women in the R-anti-D and none in the Poly anti-D group had a positive ICT result at day 90. No woman in either group had positive ICT result at day 180. Both drugs were well tolerated with only 4 reports of adverse events in each group-all were mild, non-serious, and resolved without sequelae. No subject developed antibodies against R-anti-D. Conclusion The studied R-anti-D is comparable in efficacy to conventional Poly anti-D and is safe and non-immunogenic.

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Treatment and Prevention of Rh Isoimmunization

Cited by 12 publications

References 19 publications

Rare and Multiple Alloimmunization in Antenatal Women: A Case Report

Rare and Multiple Alloimmunization in Antenatal Women: A Case Report

Prevalence of blood donor women at risk of Hemolytic disease of the Fetus and Newborn in Southern Benin

Recombinant anti-D for prevention of maternal-foetal Rh(D) alloimmunization: a randomized multi-centre clinical trial

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