Neonatal Outcome of Rh-D Alloimmunisation in Antenatal Women Attending a Tertiary Care Hospital

• Main Authors: Shaiji Panthiyil Shahulhameed, Sobha Kumar, Meena Dharmadas
• Format: Article
• Language: English
• Published: JCDR Research and Publications Pvt. Ltd. 2018-04-01
• Series: Indian Journal of Neonatal Medicine and Research
• Subjects: exchange transfusion; haemolytic disease; jaundice; newborn
• Online Access: http://www.ijnmr.net/articles/PDF/2232/34910_CE[VSU]_F(AnG)_PF1(VSU_AnG)_PFA(AnG)_PB(VSU_AnG)_PN(AnG).pdf

Introduction: Haemolytic disease of foetus and newborn due to Rh-D alloimmunisation was one of the grave complications of pregnancy years back, which contributed for a number of perinatal deaths and disabilities. Yet, advancement in technologies used for early detection and treatment of haemolytic disease of newborn as well as better neonatal care has further contributed to bring down the magnitude. Our study attempts to follow-up Rh-D alloimmunised pregnancies and collect data regarding the perinatal and postnatal plight of affected neonates. Aim: To follow-up Rh-D alloimmunised pregnancies and describe the perinatal and postnatal characteristics of affected neonates. Materials and Methods: This two year prospective study was done on Rh-D alloimmmunised women. Diagnosis of haemolytic disease of newborn due to Rh-D alloimmunisation was confirmed if a positive Direct Coomb’s Test (DCT) was found in an Rh-D positive baby. Severity of disease in terms of haemoglobin and bilirubin levels and presence of hydrops were assessed. Newborns were followed-up till discharge. Results: Out of 2496 Rh-D alloimmunised women, 78 antenatal cases were found positive for anti D-antibodies. Frequency of haemolytic disease of foetus and newborn was 57 out of 64 cases which were followed, four newborns were DCT negative although, Rh-D positive and three newborns were Rh-D negative. Mean cord Hb in unaffected newborns were significantly higher. Twenty nine out of 58 live born newborns needed no treatment. Four cases (6.25%) needed exchange transfusion. Out of 60 live born infants, 59 survived. Overall survival rate of newborns in 64 alloimmunised pregnancies was 92.18%. The survival rate in live borns was 98.33%. Conclusion: Severe cases of haemolytic disease of newborn in Rh-D alloimmunisation is limited to <10 % and after the advent of better neonatal care and monitoring services survival rates of affected newborns are much higher.