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Rh isoimmunization

MedGen UID:
11224
•Concept ID:
C0035404
•
Disease or Syndrome
Synonyms: Isoimmunization, Rh; Isoimmunization, Rhesus; Isoimmunizations, Rh; Isoimmunizations, Rhesus; Rh Isoimmunization; Rh Isoimmunizations; Rhesus Isoimmunization; Rhesus Isoimmunizations
SNOMED CT: RI - Rhesus isoimmunization (44795003); Rhesus isoimmunization in pregnancy (44795003); Rhesus isoimmunization affecting pregnancy (44795003); Rh incompatibility affecting pregnancy (44795003)
 
Monarch Initiative: MONDO:0006953

Definition

The mother develops antibodies against red blood cell Rhesus antigens. This may lead to potential fetal adverse outcomes such as anemia. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVRh isoimmunization

Professional guidelines

PubMed

Fetal anemia: Diagnosis and management.
Prefumo F, Fichera A, Fratelli N, Sartori E
Best Pract Res Clin Obstet Gynaecol 2019 Jul;58:2-14. Epub 2019 Jan 9 doi: 10.1016/j.bpobgyn.2019.01.001. PMID: 30718211
Prevention and management of RhD isoimmunization.
Harkness UF, Spinnato JA
Clin Perinatol 2004 Dec;31(4):721-42, vi. doi: 10.1016/j.clp.2004.06.005. PMID: 15519425
Management of the Rh-sensitized mother.
Gollin YG, Copel JA
Clin Perinatol 1995 Sep;22(3):545-59. PMID: 8521681

Recent clinical studies

Etiology

Induced Abortion and the Risk of Rh Sensitization.
Horvath S, Huang ZY, Koelper NC, Martinez C, Tsao PY, Zhao L, Goldberg AB, Hannum C, Putt ME, Luning Prak ET, Schreiber CA
JAMA 2023 Sep 26;330(12):1167-1174. doi: 10.1001/jama.2023.16953. PMID: 37750879Free PMC Article
Fetal-maternal incompatibility in the Rh system. Rh isoimmunization associated with hereditary spherocytosis: case presentation and review of the literature.
Neamţu SD, Novac MB, Neamţu AV, Stanca ID, Boldeanu MV, Gluhovschi A, Stanca L, Dijmărescu AL, Manolea MM, Trăistaru MR, Mateescu GO, Siminel MA
Rom J Morphol Embryol 2022 Jan-Mar;63(1):229-235. doi: 10.47162/RJME.63.1.26. PMID: 36074689Free PMC Article
Society of Family Planning committee consensus on Rh testing in early pregnancy.
Horvath S, Goyal V, Traxler S, Prager S
Contraception 2022 Oct;114:1-5. Epub 2022 Jul 21 doi: 10.1016/j.contraception.2022.07.002. PMID: 35872236
Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children.
Pegoraro V, Urbinati D, Visser GHA, Di Renzo GC, Zipursky A, Stotler BA, Spitalnik SL
PLoS One 2020;15(7):e0235807. Epub 2020 Jul 20 doi: 10.1371/journal.pone.0235807. PMID: 32687543Free PMC Article
ACOG Practice Bulletin No. 192: Management of Alloimmunization During Pregnancy.
Obstet Gynecol 2018 Mar;131(3):e82-e90. doi: 10.1097/AOG.0000000000002528. PMID: 29470342

Diagnosis

Induced Abortion and the Risk of Rh Sensitization.
Horvath S, Huang ZY, Koelper NC, Martinez C, Tsao PY, Zhao L, Goldberg AB, Hannum C, Putt ME, Luning Prak ET, Schreiber CA
JAMA 2023 Sep 26;330(12):1167-1174. doi: 10.1001/jama.2023.16953. PMID: 37750879Free PMC Article
Fetal anemia: Diagnosis and management.
Prefumo F, Fichera A, Fratelli N, Sartori E
Best Pract Res Clin Obstet Gynaecol 2019 Jul;58:2-14. Epub 2019 Jan 9 doi: 10.1016/j.bpobgyn.2019.01.001. PMID: 30718211
ACOG Practice Bulletin No. 200: Early Pregnancy Loss.
American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology
Obstet Gynecol 2018 Nov;132(5):e197-e207. doi: 10.1097/AOG.0000000000002899. PMID: 30157093
ACOG Practice Bulletin No. 192: Management of Alloimmunization During Pregnancy.
Obstet Gynecol 2018 Mar;131(3):e82-e90. doi: 10.1097/AOG.0000000000002528. PMID: 29470342
Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses.
Mari G, Deter RL, Carpenter RL, Rahman F, Zimmerman R, Moise KJ Jr, Dorman KF, Ludomirsky A, Gonzalez R, Gomez R, Oz U, Detti L, Copel JA, Bahado-Singh R, Berry S, Martinez-Poyer J, Blackwell SC
N Engl J Med 2000 Jan 6;342(1):9-14. doi: 10.1056/NEJM200001063420102. PMID: 10620643

Therapy

Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children.
Pegoraro V, Urbinati D, Visser GHA, Di Renzo GC, Zipursky A, Stotler BA, Spitalnik SL
PLoS One 2020;15(7):e0235807. Epub 2020 Jul 20 doi: 10.1371/journal.pone.0235807. PMID: 32687543Free PMC Article
Fetal anemia: Diagnosis and management.
Prefumo F, Fichera A, Fratelli N, Sartori E
Best Pract Res Clin Obstet Gynaecol 2019 Jul;58:2-14. Epub 2019 Jan 9 doi: 10.1016/j.bpobgyn.2019.01.001. PMID: 30718211
ACOG Practice Bulletin No. 200: Early Pregnancy Loss.
American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Gynecology
Obstet Gynecol 2018 Nov;132(5):e197-e207. doi: 10.1097/AOG.0000000000002899. PMID: 30157093
Practice Bulletin No. 181: Prevention of Rh D Alloimmunization.
Obstet Gynecol 2017 Aug;130(2):e57-e70. doi: 10.1097/AOG.0000000000002232. PMID: 28742673
Isoimmunization in pregnancy.
Shaver SM
Crit Care Nurs Clin North Am 2004 Jun;16(2):205-9. doi: 10.1016/j.ccell.2004.02.008. PMID: 15145363

Prognosis

Diastolic deceleration area in the fetal MCA: a new Doppler parameter.
Ignatov PN, Neykova KK, Yordanova-Ignatova T
J Matern Fetal Neonatal Med 2023 Dec;36(1):2206939. doi: 10.1080/14767058.2023.2206939. PMID: 37121906
Rh Alloimmunisation: Current Updates in Antenatal and Postnatal Management.
Sahoo T, Sahoo M, Gulla KM, Gupta M
Indian J Pediatr 2020 Dec;87(12):1018-1028. Epub 2020 Jul 1 doi: 10.1007/s12098-020-03366-0. PMID: 32607667
Vigintiphobia revisited.
Watchko JF
Pediatrics 2005 Jun;115(6):1747-53. doi: 10.1542/peds.2004-1748. PMID: 15930239
Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses.
Mari G, Deter RL, Carpenter RL, Rahman F, Zimmerman R, Moise KJ Jr, Dorman KF, Ludomirsky A, Gonzalez R, Gomez R, Oz U, Detti L, Copel JA, Bahado-Singh R, Berry S, Martinez-Poyer J, Blackwell SC
N Engl J Med 2000 Jan 6;342(1):9-14. doi: 10.1056/NEJM200001063420102. PMID: 10620643
Ectopic pregnancy.
DeCherney AH, Jones EE
Clin Obstet Gynecol 1985 Jun;28(2):365-74. doi: 10.1097/00003081-198528020-00014. PMID: 2410172

Clinical prediction guides

Induced Abortion and the Risk of Rh Sensitization.
Horvath S, Huang ZY, Koelper NC, Martinez C, Tsao PY, Zhao L, Goldberg AB, Hannum C, Putt ME, Luning Prak ET, Schreiber CA
JAMA 2023 Sep 26;330(12):1167-1174. doi: 10.1001/jama.2023.16953. PMID: 37750879Free PMC Article
Fetal-maternal incompatibility in the Rh system. Rh isoimmunization associated with hereditary spherocytosis: case presentation and review of the literature.
Neamţu SD, Novac MB, Neamţu AV, Stanca ID, Boldeanu MV, Gluhovschi A, Stanca L, Dijmărescu AL, Manolea MM, Trăistaru MR, Mateescu GO, Siminel MA
Rom J Morphol Embryol 2022 Jan-Mar;63(1):229-235. doi: 10.47162/RJME.63.1.26. PMID: 36074689Free PMC Article
Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. Collaborative Group for Doppler Assessment of the Blood Velocity in Anemic Fetuses.
Mari G, Deter RL, Carpenter RL, Rahman F, Zimmerman R, Moise KJ Jr, Dorman KF, Ludomirsky A, Gonzalez R, Gomez R, Oz U, Detti L, Copel JA, Bahado-Singh R, Berry S, Martinez-Poyer J, Blackwell SC
N Engl J Med 2000 Jan 6;342(1):9-14. doi: 10.1056/NEJM200001063420102. PMID: 10620643
Safety profile of WinRho anti-D.
Hong F, Ruiz R, Price H, Griffiths A, Malinoski F, Woloski M
Semin Hematol 1998 Jan;35(1 Suppl 1):9-13. PMID: 9523744
Immunologic disease and fetal death.
Branch DW
Clin Obstet Gynecol 1987 Jun;30(2):295-311. doi: 10.1097/00003081-198706000-00009. PMID: 3111769

Recent systematic reviews

Mirror syndrome: a systematic literature review.
Biswas S, Gomez J, Horgan R, Sibai BM, Saad A, Powel JE, Al-Kouatly HB
Am J Obstet Gynecol MFM 2023 Sep;5(9):101067. Epub 2023 Jun 28 doi: 10.1016/j.ajogmf.2023.101067. PMID: 37385374
Noninvasive Fetal RhD Blood Group Genotyping: A Systematic Review of Economic Evaluations.
Gajic-Veljanoski O, Li C, Schaink AK, Guo J, Higgins C, Shehata N, Okun N, de Vrijer B, Pechlivanoglou P, Ng V, Sikich N
J Obstet Gynaecol Can 2021 Dec;43(12):1416-1425.e5. Epub 2021 Aug 11 doi: 10.1016/j.jogc.2021.07.014. PMID: 34390866
Antenatal and postpartum prevention of Rh alloimmunization: A systematic review and GRADE analysis.
Hamel C, Esmaeilisaraji L, Thuku M, Michaud A, Sikora L, Fung-Kee-Fung K
PLoS One 2020;15(9):e0238844. Epub 2020 Sep 10 doi: 10.1371/journal.pone.0238844. PMID: 32913362Free PMC Article
Anti-D administration in pregnancy for preventing Rhesus alloimmunisation.
McBain RD, Crowther CA, Middleton P
Cochrane Database Syst Rev 2015 Sep 3;2015(9):CD000020. doi: 10.1002/14651858.CD000020.pub3. PMID: 26334436Free PMC Article
Anti-D administration in pregnancy for preventing Rhesus alloimmunisation.
Crowther CA, Middleton P, McBain RD
Cochrane Database Syst Rev 2013 Feb 28;(2):CD000020. doi: 10.1002/14651858.CD000020.pub2. PMID: 23450526

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