RH INCOMPATIBILITY

Course overview

RHESUS (RH) INCOMPATIBILITY REFERS TO THE DISCORDANT PAIRING OF MATERNAL AND FETAL RH TYPES. IT IS ASSOCIATED WITH THE DEVELOPMENT OF MATERNAL RH SENSITIZATION AND HEMOLYTIC DISEASE OF THE NEONATE (HDN). AN INDIVIDUAL CAN BE CLASSIFIED AS RH-POSITIVE IF THEIR ERYTHROCYTES EXPRESS THE RH D ANTIGEN; INDIVIDUALS WITHOUT THE RH D ANTIGEN ARE CLASSIFIED AS RH-NEGATIVE. THIS PHENOMENON BECOMES CLINICALLY SIGNIFICANT IF A MOTHER THAT IS RH-NEGATIVE BECOMES SENSITIZED TO THE D ANTIGEN AND SUBSEQUENTLY, PRODUCES ANTI-D ANTIBODIES (I.E., ALLOIMMUNIZATION) THAT CAN BIND TO AND POTENTIALLY LEAD TO THE DESTRUCTION OF RH-POSITIVE ERYTHROCYTES. THIS IS OF PARTICULAR CONCERN IF AN RH-NEGATIVE MOTHER IS CARRYING AN RH-POSITIVE FETUS, WHICH CAN RESULT IN CONSEQUENCES ALONG THE SPECTRUM OF HDN RANGING FROM SELF-LIMITED HEMOLYTIC ANEMIA TO SEVERE HYDROPS FETALIS. THIS ACTIVITY REVIEWS THE ETIOLOGY, EVALUATION, AND MANAGEMENT OF RH INCOMPATIBILITY, AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN CARING FOR AT-RISK PATIENTS.