Rhesus Disease

Question 1

Rhesus isoimmunisation

Answer 1

Question 2

Haemolytic disease of the newborn

Answer 2

• Antenatally
  
  • Polyhydramnios
  • Thickened placenta
  • Hydrops (sub-cut oedema, pleural/pericardial effusions, ascites, hepato-splenomegaly)
  • In-utero demise
• Postnatally
  
  • Jaundice
  • Hepato-splenomegaly
  • Pallor
  • Kernicterus
  • Hypoglycaemia

Question 3

Testing

Answer 3

• Check maternal blood group and titres
• Fetal blood group amino, free fetal DNA (paternal blood group)

Question 4

Methods for prevention

Answer 4

• Blood transfusion vifilance
• Anti-D prophylaxis (single dose at 28 weeks)
  
  • After management of ectopic pregnancy
  • After managment of molar pregnancy
  • Therapeutic termination of pregnancy
  • <12 weeks vaginal bleed which is heavy, repeated or associated with severe pain
  • <12 weeks medical or surgical management of miscarriage
  • Potentially sensitising event >12 weeks