Rhesus Disease in Pregnancy

Abstract

Rhesus incompatibility between mother and foetus can, if undetected and untreated, lead to Rhesus disease of the newborn: a haemolytic state which can be fatal. Screening in pregnancy allows routine prevention of Rhesus disease. Post-delivery administration of anti-D immunoglobulin to Rhesus-negative women began in the UK in 1969. As a result, the deaths attributed to RhD alloimmunization fell from 46/100 000 births before 1969 to 1.6/100000 in 1990. However, antenatal procedures and presentations commonly encountered in primary care may cause the exposure of a Rhesus-negative mother to Rhesus antigens. Awareness of Rhesus disease in routine and emergency antenatal care is therefore essential.