Management
Antenatal
- Serial Ultrasound and Doppler examinations- to detect signs of fetal anemia such as increased blood flow velocities and monitor hydrops fetalis
- Quantitative analysis of maternal anti-RhD antibodies - an increasing level is a sign of fetal Rh disease
- Intrauterine blood transfusion
- Intraperitoneal transfusion - blood transfused into fetal abdomen
- Intravascular transfusion - blood transfused into fetal umbilical vein - This is the method of choice since the late 1980s, 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 weeks 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)
Read more about this topic: Rh Disease
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