Rhesus isoimmunization sequelae

The prevention of Rhesus D alloimmunization through Rh immune globulin (RhIg) administration is the major indication for the accurate detection and quantification of fetomaternal hemorrhage (FMH). In the setting of D incompatibility, D-positive fetal cells can sensitize the D-negative mother, resulting in maternal anti-D alloantibody production. These anti-D alloantibodies may lead to undesirable sequelae such as hemolytic disease of the newborn (HDN). Since the widespread adoption of FMH screening and RhIg immunoprophylaxis, the overall risk of Rh alloimmunization and infant mortality from HDN has substantially decreased...

Late anemia is a well-recognized complication of Rhesus hemolytic disease of the newborn (HDN). The incidence of Rhesus HDN is declining, with a tendency for more severely affected pregnancies to be managed in specialist centres. Consequently, many paediatric departments may see relatively few affected infants with comparatively mild disease, and the risk of late anemia in such cases may not always be appreciated. Two cases of infants born with evidence of Rhesus isoimmunization noted at birth and encountering no immediate problems other than mild hyperbilirubinemia are described...

Amniocentesis for estimation of the lecithin: sphingomyelin (L/S) ratio was performed on 483 patients on 552 occasions. The introduction of this test has been associated with a highly significant (p less than 0-001) decrease of 59 per cent in the incidence of respiratory distress syndrome. The finding of a low L/S ratio (less than 2-0) enabled delivery to be deferred until lung maturity had been reached in 43 (10-3 per cent) of the 419 patients who had successful amniocentesis. Fetal death occurred after amniocentesis in two patients (0-41 per cent)...

The effects of previous induced abortion on pregnancy, labor and outcome of pregnancy were measured in a prospective study of 11,057 pregnancies to West Jerusalem mothers who were interviewed during pregnancy and who subsequently delivered a single live or stillborn infant. The 752 mothers who reported one or more induced abortions in the past were more likely, at the same interview, to report bleeding in each of the first 3 months of the present pregnancy. They were subsequently less likely to have a normal delivery and more of them needed a manual removal of the placenta or other intervention in the third stage of labor...