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Natl J Integr Res Med. 2014; 5(5): 38-43

Clinical and Immunohaematological Course of 64 Cases Of Antenatal Rh D Alloimmunisation At A Tertiary Care Centre In India

*Dr. Shaiji.P.S,**Dr. Meena.D,***Dr. K.C.Usha.

Background and Objectives: Incidence and outcome of Hemolytic disease of Fetus and New-born
due to RhD alloimmunisation has changed in last few decades after the advent of RhIG and other diagnostic
and therapeutic tools. But reports from different centres vary. In this study Rh D sensitised antenatal women
were followed up at Medical college, Trivandrum and clinical &laboratory profile analysed. Objectives of the
study are to describe the clinical &laboratory profile of Rh D alloimmunised pregnant ladies and to describe
severity and treatment of Hemolytic Disease in their off springs. Materials and Methods: Cross sectional study
done on 64 antenatal cases, positive for anti Rh D antibodies by ICT and followed up with serial titres and
ultrasound. Cord blood values and Direct Coombs test were used to diagnose HDFN at birth. Data was analyzed
in SPSS ver.17.catagorical data was expressed in percentages and continuous data was expressed with mean
and standard deviation. Results: Out of 2,496 Rh D negative women tested with ICT, 78 (3.12%) were
positive.54 RhD positive new-borns were DCT positive (93.1%).50.9% cases were unaffected or mild. Severe
cases accounted for 10% only. Majority (50%) received no treatment and phototherapy was the major
modality of treatment. Overall survival rate of affected new-borns was 92.18%. Out of 6 hydropic babies,
4 died in utero. Interpretations and Conclusions: Rh alloimmunisation is still prevalent among antenatal
women, but majority of cases produces only mild disease in new-born. Survival rate in newborns is >90%.
Hydropic babies have a higher death rate. Better strategies to prevent Rh D alloimmunization and introduction
of interventions like IUT are warranted. [Shaiji PS NJIRM 2014; 5(5):38-43]

Key words: clinical course, Rh D alloimmunisation, antenatal women,hemolytic disease

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