Rh incompatibility - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Rhesus (Rh) incompatibility is a condition where an Rh-negative mother carrying an Rh-positive fetus can produce antibodies against paternally derived Rh antigens on fetal red blood cells. These antibodies can cross the placenta, and destroy fetal red blood cells. It is a leading cause of hemolytic disease of the fetus and newborn, also known as erythroblastosis fetalis.
Effective immunoprophylaxis of Rh-negative at-risk mothers is key to primary prevention.
Intrauterine fetal transfusion is a lifesaving treatment for severely affected fetuses.
Survival rates are more than 90%.

Fetal hydrops, with ascites and hepatomegaly (arrow) diagnosed on prenatal ultrasound

The Ottawa Hospital; used with consent of the patient

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Definition

Epidemiology

Etiology

Pathophysiology

Images

Increased velocity in the middle cerebral artery consistent with severe fetal anemia
Fetal hydrops, with ascites and hepatomegaly (arrow) diagnosed on prenatal ultrasound
Intraperitoneal transfusion; the echogenic needle tip is visualized in the pocket of ascites

Citations

Key Articles

American Congress of Obstetrics and Gynecology. ACOG practice bulletin no. 181: prevention of Rh D alloimmunization. Obstet Gynecol. 2017 Aug;130(2):e57-70.[Abstract]
Fung KFK, Eason E. No. 133: prevention of Rh alloimmunization. J Obstet Gynaecol Can. 2018 Jan;40(1):e1-10.[Abstract]
American Congress of Obstetrics and Gynecology. ACOG practice bulletin no. 192: management of alloimmunization during pregnancy. Obstet Gynecol. 2018 Mar;131(3):e82-90.[Abstract]
Qureshi H, Massey E, Kirwan D, et al. BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn. Transfus Med. 2014 Feb;24(1):8-20.[Abstract][Full Text]
Mari G, Deter RL, Carpenter RL, et al. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. N Engl J Med. 2000 Jan 6;342(1):9-14.[Abstract][Full Text]
Visser GHA, Thommesen T, Di Renzo GC, et al. FIGO/ICM guidelines for preventing Rhesus disease: a call to action. Int J Gynaecol Obstet. 2021 Feb;152(2):144-7.[Abstract][Full Text]

Referenced Articles

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33. Mari G, Deter RL, Carpenter RL, et al. Noninvasive diagnosis by Doppler ultrasonography of fetal anemia due to maternal red-cell alloimmunization. N Engl J Med. 2000 Jan 6;342(1):9-14.[Abstract][Full Text]
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