Rh disease medical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Antenatal

• Ultrasound – to detect and monitor hydrops fetalis
• Quantitative analysis of maternal anti-RhD antibodies – an increasing level is a sign of fetal Rh disease^[1]
• Intrauterine blood transfusion
  • Intraperitoneal transfusion – blood transfused into fetal abdomen
  • Intravascular transfusion – blood transfused into fetal umbilical vein – This is more modern and more effective than intraperitoneal transfusion. A sample of fetal blood can be taken from the umbilical vein prior to the transfusion.
• Early delivery (usually after about 36 wks gestation)

Postnatal

• Phototherapy for neonatal jaundice in mild disease
• Exchange transfusion if the neonate has moderate or severe disease (the blood for transfusion must be less than a week old, Rh negative, ABO compatible with both the fetus and the mother, and be cross matched against the mothers serum)

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