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The mother can make IgG anti-Rhc antibodies, which are able to pass through the placenta and enter the fetal circulation. If the fetus is Rhc positive alloimmune hemolysis can occur leading to HDN. This is similar as for Rh disease, which is usually caused when a RhD negative mother is sensitised by her first pregnancy with a RhD positive fetus.
Cell-free DNA can be used the determine the Rh antigen of the fetus when the mother is Rh negative. Blood is taken from the mother during the pregnancy, and using PCR, can detect the K, C, c, D, and E alleles of fetal DNA. This blood test is non-invasive to the fetus and is an easy way of checking antigen status and risk of HDN.
The term "Rh Disease" is commonly used to refer to HDFN due to anti-D antibodies, and prior to the discovery of anti-Rh o (D) immune globulin, it was the most common type of HDFN. The disease ranges from mild to severe, and occurs in the second or subsequent pregnancies of Rh-D negative women when the biologic father is Rh-D positive.
Hemolytic disease of the newborn, also known as hemolytic disease of the fetus and newborn, HDN, HDFN, or erythroblastosis fetalis, [1] [2] is an alloimmune condition that develops in a fetus at or around birth, when the IgG molecules (one of the five main types of antibodies) produced by the mother pass through the placenta.
In some cases, the direct Coombs will be negative but severe, even fatal HDN can occur. [29] An indirect Coombs needs to be run in cases of anti-C, [30] anti-c, [30] and anti-M. Anti-M also recommends antigen testing to rule out the presence of HDN. [22] Hgb – the infant's hemoglobin should be tested from cord blood. [3]
Rh o (D) immune globulin (RhIG) is a medication used to prevent RhD isoimmunization in mothers who are RhD negative and to treat idiopathic thrombocytopenic purpura (ITP) in people who are Rh positive. [2] It is often given both during and following pregnancy. [2] It may also be used when RhD-negative people are given RhD-positive blood. [2]
It is usually performed on Rh-negative mothers to determine the required dose of Rho(D) immune globulin (RhIg) to inhibit formation of Rh antibodies in the mother and prevent Rh disease in future Rh-positive children. [2] It is named after Enno Kleihauer and Klaus Betke who described it in 1957.
Rh disease (Rh D) [1] ABO hemolytic disease of the newborn [1] Anti-Kell hemolytic disease of the newborn [1] Rhesus c hemolytic disease of the newborn [1] Rhesus E hemolytic disease of the newborn [1] Other blood group incompatibility (RhC, Rhe, Kidd, Duffy, MN, P and others) [1]