How to manage a case of Rh incompatibility


Clinical manifestations of Rh incompatibility.

Investigations of Rh incompatibility.

Treatment of Rh incompatibility.


Rh incompatibility

Hemolytic anaemia occuring in the new born due to transplacental transfer of fetus to maternal antibodies (Igc) to antigens on fetal red cells to haemolyse fetal red cells and these antibodies are produced by prior maternal sensitization and then immunization.

Clinical manifestations of Rh incompatibility

Three form of presentation can be occur :

  • Congenital anaemia of the newborn
  • Early jaundice of the newborn
  • Hydrops foetalis

Investigations of Rh incompatibility:

  1. Serumbilirubin
  2. Blood group and Rh typing of the infant
  3. Blood grouping and Rh typing of the parents
  4. Coomb’s test
  5. Complete blood count
  6. Reticulocyte count
  7. Peripheral blood flim

Treatment of Rh incompatibility :

  1. If the baby presents with severe anemia (cord Hb 10 gm or less) or hydrops, is an indication of immediate transfusion. If Hb level is 12gm it is safe to wait and start intensive phototherapy immediately Monitor Hb, Hct and serum bilirubin every 4-6 hourd. An exchange transfusion is performed if the bilirubin level is predicted to reach 20 mg/dl.
  2. Phototherapy.

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