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Quality in Sport

RhD alloimmunization – diagnostics, therapy and prophylaxis
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RhD alloimmunization – diagnostics, therapy and prophylaxis

Authors

  • Radoslaw Ciesielski Independent Public Hospital in Mińsk Mazowiecki, ul. Szpitalna 37, 05-300 Mińsk Mazowiecki https://orcid.org/0000-0002-3458-2024
  • Anna Mich Independent Public Hospital in Mińsk Mazowiecki, ul. Szpitalna 37, 05-300 Mińsk Mazowiecki https://orcid.org/0009-0004-6299-5506
  • Klaudia Perkowska Military Medical Institute, Szaserów 128, 04-349 Warsaw, PL https://orcid.org/0009-0001-7362-4995
  • Anna Kaźmierczak 4th Military Clinical Hospital in Wroclaw, Weigla 5, 53-114 Wroclaw, PL https://orcid.org/0009-0000-8435-6685
  • Wiktoria Izdebska J. Gromkowski Regional Specialist Hospital in Wrocław, Koszarowa 5, 51-149 Wrocław, PL https://orcid.org/0009-0005-0242-141X
  • Patrycja Sornek Military Medical Academy Memorial Teaching Hospital- Central Veteran Hospital ul. Stefana Żeromskiego 113, 90-549 Lodz, Poland https://orcid.org/0009-0003-9630-055X
  • Agata Borkowska Military Institute of Aviation Medicine, ul. Zygmunta Krasińskiego 54/56, 01-755 Warsaw, PL https://orcid.org/0009-0008-7347-7762
  • Anna Kiełb 5th Military Clinical Hospital in Krakow, ul. Wrocławska 1-3, 30-901 Krakow, Poland

 https://orcid.org/0009-0005-3152-5429
  • Igor Pawlak Independent Public Hospital in Mińsk Mazowiecki, ul. Szpitalna 37, 05-300 Mińsk Mazowiecki https://orcid.org/0009-0003-1942-9296
  • Jakub Stanek Medical University of Lodz, al. Tadeusza Kościuszki 4, 90-419 Łódź https://orcid.org/0000-0002-9450-7261

DOI:

https://doi.org/10.12775/QS.2024.32.56059

Keywords

alloimmunization in pregnancy, serological conflict, fetal anemia, prophylaxis

Abstract

Introduction:

The success in preventing and treating Rh D alloimmunization is a major accomplishment in modern obstetrics. The widespread use of Rh D immune globulin has led to a decline in red cell alloimmunization. Despite evidence of its effectiveness, many cases of Rh D alloimmunization persist due to non-compliance with established protocols. Implementing routine anti-D prophylaxis (RAADP) during the third trimester is well-established but requires more careful.

Aim of study:

The aim of the study is to summarize the available knowledge about alloimmunization in pregnancy and methods of prophylaxis. The definition, patomechanism, methods of treatment and prophylaxis were summarized and described.

Materials and methods:

The literature available in PubMed database was reviewed using following keywords: “alloimmunization in pregnancy”, “serological conflict”, “fetal anemia”, “HDFN”, “prophylaxis of alloimmunization”.

Conclusion:

Advancements in diagnosing, treating, and preventing hemolytic disease of the fetus and newborn are notable. Quick, non-invasive diagnostics have facilitated more efficient treatment implementation. Prevention methods include specific and nonspecific prophylaxis, which can start during or after pregnancy. Numerous guidelines and studies exist regarding immunoglobulin use in pregnancy. However, medical staff education on managing hemolytic disease during pregnancy is crucial.

References

Klein HG, Anstee DJ. Haemolytic Disease of the Fetus and the Newborn. Mollison’s Blood Transfusion in Clinical Medicine. Oxford, UK: Blackwell Science Ltd; 2005:496Y545.

Kjeldsen-Kragh J, Skogen B. Mechanisms and prevention of alloimmunization in pregnancy. Obstet Gynecol Surv. 2013 Jul;68(7):526-32.

Weinstein L. Irregular antibodies causing hemolytic disease of the newborn: a continuing problem. Clin Obstet Gynecol 1982;25:321-32.

Roberts IA. The changing face of haemolytic disease of the newborn. Early Hum Dev 2008;84:515-23.

Nordvall M, Dziegiel M, Hegaard HK, et al. Red blood cell antibodies in pregnancy and their clinical consequences: synergistic effects of multiple specificities. Transfusion 2009;49:2070-5.

Koelewijn JM, Vrijkotte TG, van der Schoot CE, et al. Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: a population study in the Netherlands. Transfusion 2008;48:941-52.

Lo YM, Bowell PJ, Selinger M, Mackenzie IZ, Chamberlain P, Gillmer MD ,et al. Prenatal determination of fetal Rh D status by analysis of peripheral blood of rhesus negative mothers. Lancet 1993;341:1147e8.

Abbasi N, Johnson JA, Ryan G. Fetal anemia. Ultrasound Obstet Gynecol 2017;50:145e53.

Moise Jr KJ,Argoti PS. Management and prevention of red cell alloimmunization in pregnancy: a systematic review. Obstet Gynecol 2012;120:1132e9.

Oepkes D, Seaward PG, Vandenbussche FP, Windrim R, Kingdom J, Beyene J, et al. Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 2006;355:156e64.

Nicolini U, Nicolaidis P, Fisk NM, Tannirandorn Y, Rodeck CH. Fetal blood sampling from the intrahepatic vein: analysis of safety and clinical experience with 214 procedures. Obstet Gynecol 1990;76:47e53.

Zwiers C, van Kamp I, Oepkes D, Lopriore E. Intrauterine transfusion and non-invasive treatment options for hemolytic disease of the fetus and newborn - review on current management and outcome. Expert Rev Hematol 2017;10:337e44.

Zwiers C, Lindenburg ITM, Klumper FJ, de Haas M, Oepkes D, Van Kamp IL. Complications of intrauterine intravascular blood transfusion: lessons learned after 1678 procedures. Ultrasound Obstet Gynecol 2017;50:180e6.

Prefumo F, Fichera A, Fratelli N, Sartori E. Fetal anemia: Diagnosis and management. Best Pract Res Clin Obstet Gynaecol. 2019 Jul;58:2-14.

Mari G, Norton ME, Stone J, Berghella V, Sciscione AC, Tate D, et al. Society for maternal-fetal medicine (SMFM) clinical guideline #8: the fetus at risk for anemia– diagnosis and management. Am J Obstet Gynecol 2015;212:697e710.

Voto LS, Mathet ER, Zapaterio JL, Orti J, Lede RL, Margulies M. High-dose gammaglobulin (IVIG) followed by intrauterine transfusions (IUTs): a new alternative for the treatment of severe fetal hemolytic disease. J Perinat Med 1997;25:85e8.

Zwiers C, van der Bom JG, van Kamp IL, van Geloven N, Lopriore E, Smoleniec J, et al. Postponing Early intrauterine Transfusion with Intravenous immunoglobulin Treatment; the PETIT study on severe hemolytic disease of the fetus and newborn. Am J Obstet Gynecol 2018;219. 291 e291e291 e299.

de Haas M, Finning K, Massey E, Roberts DJ. Anti-D prophylaxis: past, present and future. Transfus Med. 2014;24:1–7

Bowman J. Thirty-five years of Rh prophylaxis. Transfusion 2003;43:1661–6.

Pollack W, Ascari WQ, Kochesky RJ, O’Connor RR, Ho TY, Tripodi D. Studies on Rh prophylaxis. 1. Relationship between doses of anti-Rh and size of antigenic stimulus.

Transfusion 1971;11:333–9.

Beveridge HE. Dwindling supplies of anti-D. Med J Aust 1997;167:509–10.

Robson SC, Lee D, Urbaniak S. Anti-D immunoglobulin in RhD prophylaxis. Br J

Obstet Gynaecol 1998;105:129–34.

de Crespigny L, Davison G. Anti-D administration in early pregnancy - time for a new protocol. Aust N Z J Obstet Gynaecol 1995;35:385–7.

Fung MK, Grossman BJ, Hillyer CD, Westhoff CM, edi- tors. Technical manual. 18th ed. Bethesda (MD): American Association of Blood Banks; 2014.

Qureshi H, Massey E, Kirwan D, Davies T, Robson S, White J, et al. BCSH guideline for the use of anti- D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. British Society for Haematology. Transfus Med 2014;24:8–20.

Fung Kee Fung K, Eason E, Crane J, Armson A, De La Ronde S, Farine D, et al. Prevention of Rh alloimmuni- zation. Maternal–Fetal Medicine Committee, Genetics Committee. J Obstet Gynaecol Can 2003;25:765–73.

Bowman JM. The prevention of Rh immunization. Transfus Med Rev 1988;2:129–50.

McMaster conference on prevention of Rh immuniza- tion. 28–30 September, 1977.

Vox Sang 1979;36:50–64.

National Institute for Health and Care Excellence. Routine antenatal anti-D prophylaxis

for women who are rhesus D negative. Technology appraisal guidance TA156. London

(UK): NICE; 2008.

Qureshi H, Massey E, Kirwan D, Davies T, Robson S, White J, et al. BCSH guideline

for the use of anti- D immunoglobulin for the prevention of haemolytic disease of the

fetus and newborn. British Society for Haematology. Transfus Med 2014;24:8–20.

MacKenzie IZ, Dutton S, Roseman F. Evidence to sup- port the single-dose over the two-dose protocol for rou- tine antenatal anti-D Rhesus prophylaxis: a prospective

observational study. Eur J Obstet Gynecol Reprod Biol 2011;158:42–6.

Vick S, Cairns J, Urbaniak S, Whitfield C, Raafat A. Cost-effectiveness of antenatal

anti-D prophylaxis. Health Econ 1996;5:319–28.

Fyfe TM, Ritchey MJ, Taruc C, Crompton D, Galliford B, Perrin R. Appropriate

provision of anti-D prophylaxis to RhD negative pregnant women: a scoping review.

BMC Pregnancy Childbirth 2014;14:411.

McBain RD, Crowther CA, Middleton P. Anti-D administration in pregnancy for

preventing Rhesus alloimmunisation. Cochrane Database of Systematic Reviews 2015,

Issue 9. Art. No.: CD000020.

Badami KG, Parker J, Kenny A, Warrington S. Incidence of maternal sensitisation to

Rh(D) in Christchurch, New Zealand and reasons for prophylaxis failures. N Z Med J 2014;127:40–6.

Hughes RG, Craig JI, Murphy WG, Greer IA. Causes and clinical consequences of Rhesus (D) haemolytic disease of the newborn: a study of a Scottish population, 1985– 1990. Br J Obstet Gynaecol 1994;101:297–300.

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Published

2024-12-02

How to Cite

1.
CIESIELSKI, Radoslaw, MICH, Anna, PERKOWSKA, Klaudia, KAŹMIERCZAK, Anna, IZDEBSKA, Wiktoria, SORNEK, Patrycja, BORKOWSKA, Agata, KIEŁB, Anna, PAWLAK, Igor and STANEK, Jakub. RhD alloimmunization – diagnostics, therapy and prophylaxis. Quality in Sport. Online. 2 December 2024. Vol. 32, p. 56059. [Accessed 28 June 2025]. DOI 10.12775/QS.2024.32.56059.
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Issue

Vol. 32 (2024)

Section

Medical Sciences

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Copyright (c) 2024 Radoslaw Ciesielski, Anna Mich, Klaudia Perkowska, Anna Kaźmierczak, Wiktoria Izdebska, Patrycja Sornek, Anna Kiełb, Igor Pawlak, Jakub Stanek, Agata Borkowska

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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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