Materiały źródłowe

• #1

  https://www.nhs.uk/conditions/rhesus-disease/treatment/

  Treatment for rhesus disease depends on how severe the condition is. In more severe cases, treatment may need to begin before the baby is born. […] In more severe cases, a treatment called phototherapy is usually needed and blood transfusions may help to speed up the removal of bilirubin (a substance created when red blood cells break down) from the body. […] In the most serious cases, a blood transfusion may be carried out while your baby is still in the womb and a medication called intravenous immunoglobulin may be used when they’re born if phototherapy isn’t effective. […] Phototherapy is treatment with light. It involves placing the newborn baby under a halogen or fluorescent lamp with their eyes covered. […] The light absorbed by the skin during phototherapy lowers the bilirubin levels in the baby’s blood through a process called photo-oxidation.

• #2

  https://www.nhs.uk/conditions/rhesus-disease/

  If an unborn baby does develop rhesus disease, treatment depends on how severe it is. A blood transfusion to the unborn baby may be needed in more severe cases. After delivery, the child is likely to be admitted to a neonatal unit (a hospital unit that specialises in caring for newborn babies). […] Treatment for rhesus disease after delivery can include a light treatment called phototherapy, blood transfusions, and an injection of a solution of antibodies (intravenous immunoglobulin) to prevent red blood cells being destroyed. […] If rhesus disease is left untreated, severe cases can lead to stillbirth. In other cases, it could lead to brain damage, learning difficulties, hearing loss and blindness and vision loss. However, treatment is usually effective and these problems are uncommon.

• #3 Rhesus (Rh) Factor: Incompatibility, Complications & Pregnancy

  https://my.clevelandclinic.org/health/diseases/21053-rh-factor

  During pregnancy, complications may occur if you’re Rh-negative and the fetus is Rh-positive. This is called Rh factor incompatibility. Treatments are available to prevent complications of Rh incompatibility. […] Rh immune globulin (RhIg or RhoGAM) is a medication that stops your body from making Rh antibodies. It’s only helpful if your body hasn’t already made Rh antibodies. You receive it as a shot (injection). Rh immunoglobulin shots are usually very successful in treating Rh-incompatibility during pregnancy. Detecting Rh incompatibility early in pregnancy is the best way to prevent serious complications. […] If your body already has Rh antibodies, the fetus is at risk for Rh disease. Since Rh immune globulin won’t be helpful, the best treatment is close monitoring for the remainder of your pregnancy. There’s a small chance your provider will want to deliver early, but this depends on how severe the fetus’s Rh disease is. […] Treatment with Rh immune globulin won’t help if an Rh-negative woman has already made antibodies. This is why it’s important to know your Rh factor and get treatment as soon as possible.

• #4 Rh disease – Wikipedia

  https://en.wikipedia.org/wiki/Rh_disease

  Due to several advances in modern medicine, HDFN due to anti-D is preventable by treating the mother during pregnancy and soon after delivery with an injection of anti-Rho(D) immune globulin (Rhoclone, Rhogam, AntiD). […] The protection that is offered today against Rh incompatibility involved preventive measures that primarily utilize Rh immunoglobulin, also known as RhoGAM. […] RhoGAM, Rh immunoglobulin administration, is a product that contains antibodies to the Rh(D) antigen; it is used to prevent the mother from developing an immune response to fetal red blood cells. […] RhoGAM is typically administered at around 28 weeks of pregnancy, then again within 72 hours after childbirth. […] If the flow velocity is found to be elevated a determination of the severity of anemia needs to ensue to determine if an intrauterine transfusion is necessary.

• #5 Rh Incompatibility (for Parents) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/rh.html

  Rh incompatibility usually isn’t a problem if it’s the mother’s first pregnancy. […] If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She’ll get: the first shot around the 28th week of pregnancy, the second shot within 72 hours of giving birth. […] Rh immune-globulin acts like a vaccine. It prevents the mother’s body from making any Rh antibodies that could cause serious health problems in the newborn or affect a future pregnancy. […] In rare cases, if the incompatibility is severe and a baby is in danger, the baby can get special blood transfusions called exchange transfusions either before birth (intrauterine fetal transfusions) or after delivery. Exchange transfusions replace the baby’s blood with blood with Rh-negative blood cells. This stabilizes the level of red blood cells and minimizes damage from Rh antibodies already in the baby’s bloodstream. […] Thanks to the success rate of Rh immune-globulin shots, exchange transfusions in Rh-incompatible pregnancies are rarely needed in the United States.

• #6 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02498

  Treatment will depend on your pregnancy and general health. It will also depend on how severe the condition is. […] This test puts red blood cells into your baby’s circulation. In this test, a needle is placed through your uterus. It goes into your babys abdominal cavity to a vein in the umbilical cord. Your baby may need sedative medicine to keep from moving. You may need to have more than 1 transfusion. […] If your baby gets certain complications, your baby may need to be born early. Your healthcare provider may induce labor once your baby has mature lungs. […] Rh disease can be prevented. Almost all people will have a blood test to learn their blood type early in pregnancy. […] If youre Rh negative and have not been sensitized, youll get a medicine called Rh immunoglobulin (RhoGAM). This medicine can stop your antibodies from reacting to your babys Rh positive cells. Youll get RhoGAM around week 28 of pregnancy. You may get it earlier if you have vaginal bleeding, trauma, or amniocentesis before 28 weeks. […] If your baby is Rh positive, youll get a second dose of medicine within 72 hours of giving birth. If your baby is Rh negative, you wont need a second dose.

• #7 Rh disease | March of Dimes

  https://www.marchofdimes.org/find-support/topics/planning-baby/rh-disease

  Rh disease is preventable. Treatment during pregnancy can protect your baby and future pregnancies. […] If youre Rh-negative, can you protect your baby from Rh disease? Rh disease can be prevented in your baby if you get treatment at the right times. If you havent developed Rh antibodies, your provider can give you a shot of Rh immunoglobulin called Rho(D) immune globulin (brand name RhoGAM). RhoGAM can prevent your body from producing Rh antibodies so your baby and future pregnancies wont get Rh disease. […] If your baby has Rh disease, she can be treated to help prevent serious health problems. […] If your baby develops severe Rh disease and severe anemia before birth, you may have to give birth early, before her due date. She may need a blood transfusion with new blood to replace red blood cells that the Rh antibodies destroyed. Babies can get a blood transfusion in the womb as early as 18 weeks of pregnancy; they also can get a transfusion after birth.

• #8 Rh Incompatibility (for Parents) (for Parents) | Nemours KidsHealth

  https://kidshealth.org/en/parents/rh.html

  Rh incompatibility usually isn’t a problem if it’s the mother’s first pregnancy. […] If a pregnant woman has the potential to develop Rh incompatibility, doctors give her a series of two Rh immune-globulin shots during her first pregnancy. She’ll get: the first shot around the 28th week of pregnancy, the second shot within 72 hours of giving birth. […] Rh immune-globulin acts like a vaccine. It prevents the mother’s body from making any Rh antibodies that could cause serious health problems in the newborn or affect a future pregnancy. […] In rare cases, if the incompatibility is severe and a baby is in danger, the baby can get special blood transfusions called exchange transfusions either before birth (intrauterine fetal transfusions) or after delivery. Exchange transfusions replace the baby’s blood with blood with Rh-negative blood cells. This stabilizes the level of red blood cells and minimizes damage from Rh antibodies already in the baby’s bloodstream. […] Thanks to the success rate of Rh immune-globulin shots, exchange transfusions in Rh-incompatible pregnancies are rarely needed in the United States.

• #9 The Rh Factor: How It Can Affect Your Pregnancy | ACOG

  https://www.acog.org/womens-health/faqs/the-rh-factor-how-it-can-affect-your-pregnancy

  During pregnancy, problems can occur if you are Rh negative and your fetus is Rh positive. Treatment can be given to prevent these problems. […] Yes, problems during pregnancy caused by Rh incompatibility can be prevented. The goal of treatment is to stop an Rh-negative woman from making Rh antibodies in the first place. This is done by finding out if you are Rh negative early in pregnancy (or before pregnancy) and, if needed, giving you a medication to prevent antibodies from forming. […] Rh immunoglobulin (RhIg) is a medication that stops the body from making Rh antibodies if it has not already made them. This can prevent severe fetal anemia in a future pregnancy. RhIg is given as an injection (shot). […] A dose of RhIg is recommended in these situations: After a miscarriage or abortion at 12 weeks or more of pregnancy […] If ultrasound exams show that the fetus has severe anemia, early delivery (before 37 weeks of pregnancy) may be needed. Another option may be to give a blood transfusion through the umbilical cord while the fetus is still in the woman’s uterus.

• #10 Rhesus disease & its treatment | Huggies®

  https://www.huggiesarabia.com/en-sa/articles/pregnancy/pregnancy-complications/rhesus-disease

  Rhesus Disease can be prevented by giving a Rh-negative mother an injection of a special compound known as Anti D within 72 hours of her having her baby. […] Treatment of Haemolytic Disease of the Newborn involves blood transfusions to bring the baby’s iron levels up to within a healthy and normal range. […] This is an injection which is given to Rh-negative mothers within 72 hours of giving birth. This prevents the mother from producing anti-D antibodies which could potentially cause problems with her future pregnancies. […] Women who are Rh-negative should receive an injection of anti-D when they have miscarried, if they had a termination of pregnancy, if they have had any trauma or bleeding during the pregnancy, during amniocentesis, if they have had any abdominal trauma, or after an ectopic pregnancy.

• #11 Rh Incompatibility Treatment & Management: Prehospital Care, Emergency Department Care

  https://emedicine.medscape.com/article/797150-treatment

  When possible, prehospital care personnel should direct their efforts on stabilization of the mother and infant, followed by immediate transport to a facility specializing in high-risk obstetric and neonatal care. […] ED care of the pregnant woman with Rh-negative blood and a suspected fetomaternal hemorrhage varies depending on the presentation of the patient and the gestational age of the fetus. […] If the mother has Rh-negative blood and has not been sensitized previously, administer human anti-D immune globulin (Rh IgG or RhoGAM) and refer the woman for further evaluation. […] If the mother has been sensitized previously, as determined by elevated level of maternal Rh antibodies, administration of Rh IgG is of no value. In this situation, prompt referral to a center that specializes in high-risk obstetrics is warranted.

• #12 Rhesus (Rh) Factor: Incompatibility, Complications & Pregnancy

  https://my.clevelandclinic.org/health/diseases/21053-rh-factor

  During pregnancy, complications may occur if you’re Rh-negative and the fetus is Rh-positive. This is called Rh factor incompatibility. Treatments are available to prevent complications of Rh incompatibility. […] Rh immune globulin (RhIg or RhoGAM) is a medication that stops your body from making Rh antibodies. It’s only helpful if your body hasn’t already made Rh antibodies. You receive it as a shot (injection). Rh immunoglobulin shots are usually very successful in treating Rh-incompatibility during pregnancy. Detecting Rh incompatibility early in pregnancy is the best way to prevent serious complications. […] If your body already has Rh antibodies, the fetus is at risk for Rh disease. Since Rh immune globulin won’t be helpful, the best treatment is close monitoring for the remainder of your pregnancy. There’s a small chance your provider will want to deliver early, but this depends on how severe the fetus’s Rh disease is. […] Treatment with Rh immune globulin won’t help if an Rh-negative woman has already made antibodies. This is why it’s important to know your Rh factor and get treatment as soon as possible.

• #13 Management of neonatal Rh disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8521682/

  Dramatic improvements have been made in the management of Rh disease. Anti-D immune globulin has reduced the incidence of Rh sensitization. Intrauterine transfusions have become routine to treat fetal anemia. […] Once an affected infant is born, several recent improvements in neonatal care have aided in the treatment of hyperbilirubinemia. These include improved phototherapy, such as fiberoptic delivery systems, and intravenous immunoglobulin. Experience with heme oxygenase inhibitors is accumulating, and they may prove efficacious in Rh disease. Double-volume (and perhaps single-volume) exchange transfusion remains an effective method to control hyperbilirubinemia when other therapies fail. Erythropoietin may have a role in treating late, hyporegenerative anemia. Finally, better ways to assess the risk of brain injury in patients with hyperbilirubinemia may become available. Cooperation between the obstetric and neonatal teams to treat Rh-sensitized mothers and their babies is essential.

• #14 Rh Disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/rh-disease

  Specific treatment for Rh disease will be determined by your doctor based on: […] Treatments for Rh disease may include: […] Intrauterine blood transfusion of red blood cells into the baby’s circulation. A procedure that is performed by placing a needle through the mother’s uterus and into the abdominal cavity of the fetus or directly into the vein in the umbilical cord. It may be necessary to give a sedative medication to keep the baby from moving. Intrauterine transfusions may need to be repeated. […] Early delivery, if the fetus develops complications (if the fetus has mature lungs, labor and delivery may be induced to prevent worsening of the disease)

• #15 Rh disease – Wikipedia

  https://en.wikipedia.org/wiki/Rh_disease

  Intrauterine blood transfusion […] Intravascular transfusion blood transfused into fetal umbilical vein This is the method of choice since the late 1980s, and more effective than intraperitoneal transfusion. […] Exchange transfusion if the neonate has moderate or severe disease. […] Intravenous immunoglobulin (IVIG) can be used to reduce the need for exchange transfusion and to shorten the length of phototherapy.

• #16

  https://www.nhs.uk/conditions/rhesus-disease/treatment/

  Using phototherapy can sometimes reduce the need for a blood transfusion. […] In some cases, the levels of bilirubin in the blood may be high enough to require one or more blood transfusions. […] This process helps to remove some of the bilirubin in the baby’s blood and also removes the antibodies that cause rhesus disease. […] If your baby develops rhesus disease while still in the womb, they may need to be given a blood transfusion before birth. This is known as intrauterine foetal blood transfusion. […] You may need more than one intrauterine foetal blood transfusion. Transfusions can be repeated every 2 to 4 weeks until your baby is mature enough to be delivered. […] In some cases, treatment with intravenous immunoglobulin (IVIG) is used alongside phototherapy if the level of bilirubin in your baby’s blood continues to rise at an hourly rate.

• #17 Rh Disease – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=rh-disease-90-P02498

  Treatment will depend on your pregnancy and general health. It will also depend on how severe the condition is. […] This test puts red blood cells into your baby’s circulation. In this test, a needle is placed through your uterus. It goes into your babys abdominal cavity to a vein in the umbilical cord. Your baby may need sedative medicine to keep him or her from moving. You may need to have more than one transfusion. […] If your baby gets certain complications, he or she may need to be born early. Your healthcare provider may induce labor once your baby has mature lungs.

• #18 Medical Management of Rhesus Disease | Article | GLOWM

  https://www.glowm.com/article/heading/vol-16–the-prevention-and-management-of-rh-disease–medical-management-of-rhesus-disease/id/418123

  Fetal red cell destruction by maternal antibodies remains an important cause of fetal and neonatal morbidity and mortality. Intrauterine fetal blood transfusion is the therapy of choice for severe hemolytic disease of the fetus. […] Non-invasive, medical treatments are important to minimize or avoid procedure-related risks. Intravenous immunoglobin (IVIg) and novel monoclonal antibody (M281, nipocalimab) treatments may attenuate the transplacental passage and fetal effects of IgG antibodies. By delaying the onset of fetal anemia, immunological therapies can defer the need for first transfusion. These medical therapies in early onset hemolytic disease of the fetus and newborn (HDFN) improve fetal survival. […] Pregnancies with early-onset fetal anemia (prior to 22 weeks) are the main beneficiaries of medical treatments, which dampen the alloimmune antibody-mediated red cell destruction, as they have the highest rates of procedure-related fetal loss.

• #19 Treatment | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/rhesus-disease/treatment

  Intravenous immunoglobulin helps to prevent red blood cells being destroyed, so the level of bilirubin in your baby’s blood will stop rising. It also reduces the need for a blood transfusion. […] Intravenous immunoglobulin has also been used during pregnancy, in particularly severe cases of rhesus disease, as it can delay the need for treatment with intrauterine foetal blood transfusions.

• #20 Medical Management of Rhesus Disease | Article | GLOWM

  https://www.glowm.com/article/heading/vol-16–the-prevention-and-management-of-rh-disease–medical-management-of-rhesus-disease/id/418123

  Fetal red cell destruction by maternal antibodies remains an important cause of fetal and neonatal morbidity and mortality. Intrauterine fetal blood transfusion is the therapy of choice for severe hemolytic disease of the fetus. […] Non-invasive, medical treatments are important to minimize or avoid procedure-related risks. Intravenous immunoglobin (IVIg) and novel monoclonal antibody (M281, nipocalimab) treatments may attenuate the transplacental passage and fetal effects of IgG antibodies. By delaying the onset of fetal anemia, immunological therapies can defer the need for first transfusion. These medical therapies in early onset hemolytic disease of the fetus and newborn (HDFN) improve fetal survival. […] Pregnancies with early-onset fetal anemia (prior to 22 weeks) are the main beneficiaries of medical treatments, which dampen the alloimmune antibody-mediated red cell destruction, as they have the highest rates of procedure-related fetal loss.

• #21 Rhesus pregnancy: immunotherapy to protect the foetus • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/rhesus-pregnancy-therapy-protect-foetus.html

  A new study shows that nipocalimab is a good alternative to mitigate the risks of a blood transfusion in a rhesus pregnancy: the drug ensures that the mother’s antibodies can no longer go to the foetus. […] The excellent results of immunotherapy with nipocalimab can therefore be a game changer for the follow-up of women with a rhesus pregnancy. […] A new study show that the drug nipocalimab is a good alternative. […] After treatment with the drug nipocalimab 13 out of the 14 babies survived: a very good result, especially if you know that rhesus disease and the immunity problem usually get worse in ever pregnancy. […] The results of the phase 2 study are encouraging for the phase 3 study that will now be started. […] If the product can be approved after that phase 3 study, it could be the first non-surgical treatment for rhesus pregnancies.

• #22 Rhesus pregnancy: immunotherapy to protect the foetus • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/rhesus-pregnancy-therapy-protect-foetus.html

  It is the first time that we have found a drug that can prevent the mother’s antibodies to transfer to the foetus. […] The excellent results of immunotherapy with nipocalimab can therefore be a game changer for the follow-up of women with a rhesus pregnancy. […] Also in other foetal diseases caused by the wrong combination of antibodies in the foetus and the mother, this kind of immunotherapy may be important.

• #23 Rh Disease | Children’s Hospital of Philadelphia

  https://www.chop.edu/conditions-diseases/rh-disease

  Specific treatment for Rh disease will be determined by your doctor based on: […] Treatments for Rh disease may include: […] Intrauterine blood transfusion of red blood cells into the baby’s circulation. A procedure that is performed by placing a needle through the mother’s uterus and into the abdominal cavity of the fetus or directly into the vein in the umbilical cord. It may be necessary to give a sedative medication to keep the baby from moving. Intrauterine transfusions may need to be repeated. […] Early delivery, if the fetus develops complications (if the fetus has mature lungs, labor and delivery may be induced to prevent worsening of the disease)

• #24 Hemolytic Disease of the Newborn (HDN) – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=hemolytic-disease-of-the-newborn-hdn-90-P02368

  How is HDN treated in a newborn? Treatment will depend on your childs symptoms, age, and general health. It will also depend on how severe the condition is. […] During pregnancy, treatment for HDN may include the following. Monitoring A healthcare provider will check your babys blood flow with an ultrasound. […] Intrauterine blood transfusion This test puts red blood cells into your baby’s circulation. In this test, a needle is placed through your uterus. It goes into your babys abdominal cavity to a vein in the umbilical cord. Your baby may need sedative medicine to keep him or her from moving. You may need to have more than 1 transfusion. […] Early delivery If your baby gets certain complications, he or she may need to be born early. Your healthcare provider may induce labor may once your baby has mature lungs. This can keep HDN from getting worse.

• #25

  https://www.nhs.uk/conditions/rhesus-disease/

  If an unborn baby does develop rhesus disease, treatment depends on how severe it is. A blood transfusion to the unborn baby may be needed in more severe cases. After delivery, the child is likely to be admitted to a neonatal unit (a hospital unit that specialises in caring for newborn babies). […] Treatment for rhesus disease after delivery can include a light treatment called phototherapy, blood transfusions, and an injection of a solution of antibodies (intravenous immunoglobulin) to prevent red blood cells being destroyed. […] If rhesus disease is left untreated, severe cases can lead to stillbirth. In other cases, it could lead to brain damage, learning difficulties, hearing loss and blindness and vision loss. However, treatment is usually effective and these problems are uncommon.

• #26

  https://www.nhs.uk/conditions/rhesus-disease/treatment/

  Treatment for rhesus disease depends on how severe the condition is. In more severe cases, treatment may need to begin before the baby is born. […] In more severe cases, a treatment called phototherapy is usually needed and blood transfusions may help to speed up the removal of bilirubin (a substance created when red blood cells break down) from the body. […] In the most serious cases, a blood transfusion may be carried out while your baby is still in the womb and a medication called intravenous immunoglobulin may be used when they’re born if phototherapy isn’t effective. […] Phototherapy is treatment with light. It involves placing the newborn baby under a halogen or fluorescent lamp with their eyes covered. […] The light absorbed by the skin during phototherapy lowers the bilirubin levels in the baby’s blood through a process called photo-oxidation.

• #27 Treatment | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/rhesus-disease/treatment

  Treatment for rhesus disease depends on how severe the condition is. In more severe cases, treatment may need to begin before the baby is born. […] In more severe cases, a treatment called phototherapy is usually needed and blood transfusions may help to speed up the removal of bilirubin (a substance created when red blood cells break down) from the body. […] In the most serious cases, a blood transfusion may be carried out while your baby is still in the womb and a medication called intravenous immunoglobulin may be used when they’re born if phototherapy isn’t effective. […] Phototherapy is treatment with light. It involves placing the newborn baby under a halogen or fluorescent lamp with their eyes covered. […] The light absorbed by the skin during phototherapy lowers the bilirubin levels in the baby’s blood through a process called photo-oxidation.

• #28 Hemolytic disease of the newborn: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001298.htm

  Infants with HDN may be treated with: […] Light therapy (phototherapy) using special blue lights to convert bilirubin into a form which is easier for the baby’s body to get rid of. […] Antibodies (intravenous immunoglobulin, or IVIG) to help protect the baby’s red cells from being destroyed. […] In severe cases, an exchange transfusion may need to be performed. This involves removing a large amount of the baby’s blood, and thus the extra bilirubin and antibodies. Fresh donor blood is infused. […] Simple transfusion (without exchange). This may need to be repeated after the baby goes home from the hospital.

• #29 Hemolytic Disease of the Newborn (HDN) – Stanford Medicine Children’s Health

  https://www.stanfordchildrens.org/en/topic/default?id=hemolytic-disease-of-the-newborn-hdn-90-P02368

  After birth, treatment may include the following. Blood transfusions This may be done if your baby has severe anemia. […] Intravenous fluids This may be done if your baby has low blood pressure. […] Phototherapy In this test, your baby is put under a special light. This helps your baby get rid of extra bilirubin. […] Help with breathing Your baby may need oxygen, a substance in the lungs that helps keep the tiny air sacs open (surfactant), or a mechanical breathing machine to breathe better. […] Exchange transfusion This test removes your babys blood that has a high bilirubin level. It replaces it with fresh blood that has a normal bilirubin level. This raises your babys red blood cell count. It also lowers his or her bilirubin level. In this test, your baby will alternate giving and getting small amounts of blood. This will be done through a vein or artery. Your baby may need to have this procedure again if his or her bilirubin levels stay high. […] Intravenous immunoglobulin (IVIG) IVIG is a solution made from blood plasma. It contains antibodies to help the baby’s immune system. IVIG reduces your babys breakdown of red blood cells. It may also lower his or her bilirubin levels.

• #30 Hemolytic disease of the newborn: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/001298.htm

  Infants with HDN may be treated with: […] Light therapy (phototherapy) using special blue lights to convert bilirubin into a form which is easier for the baby’s body to get rid of. […] Antibodies (intravenous immunoglobulin, or IVIG) to help protect the baby’s red cells from being destroyed. […] In severe cases, an exchange transfusion may need to be performed. This involves removing a large amount of the baby’s blood, and thus the extra bilirubin and antibodies. Fresh donor blood is infused. […] Simple transfusion (without exchange). This may need to be repeated after the baby goes home from the hospital.

• #31

  https://www.nhs.uk/conditions/rhesus-disease/treatment/

  Intravenous immunoglobulin helps to prevent red blood cells being destroyed, so the level of bilirubin in your baby’s blood will stop rising. It also reduces the need for a blood transfusion. […] Concerns over possible side effects, and the limited supply of intravenous immunoglobulin, mean that it’s only used when the bilirubin level is rising rapidly, despite phototherapy sessions.

• #32 Treatment | NICS Well

  https://www.nicswell.co.uk/conditions-and-treatments/rhesus-disease/treatment

  Intravenous immunoglobulin helps to prevent red blood cells being destroyed, so the level of bilirubin in your baby’s blood will stop rising. It also reduces the need for a blood transfusion. […] Intravenous immunoglobulin has also been used during pregnancy, in particularly severe cases of rhesus disease, as it can delay the need for treatment with intrauterine foetal blood transfusions.

• #33

  https://www.nhs.uk/conditions/rhesus-disease/treatment/

  Intravenous immunoglobulin helps to prevent red blood cells being destroyed, so the level of bilirubin in your baby’s blood will stop rising. It also reduces the need for a blood transfusion. […] Concerns over possible side effects, and the limited supply of intravenous immunoglobulin, mean that it’s only used when the bilirubin level is rising rapidly, despite phototherapy sessions.

• #34 Management of neonatal Rh disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8521682/

  Dramatic improvements have been made in the management of Rh disease. Anti-D immune globulin has reduced the incidence of Rh sensitization. Intrauterine transfusions have become routine to treat fetal anemia. […] Once an affected infant is born, several recent improvements in neonatal care have aided in the treatment of hyperbilirubinemia. These include improved phototherapy, such as fiberoptic delivery systems, and intravenous immunoglobulin. Experience with heme oxygenase inhibitors is accumulating, and they may prove efficacious in Rh disease. Double-volume (and perhaps single-volume) exchange transfusion remains an effective method to control hyperbilirubinemia when other therapies fail. Erythropoietin may have a role in treating late, hyporegenerative anemia. Finally, better ways to assess the risk of brain injury in patients with hyperbilirubinemia may become available. Cooperation between the obstetric and neonatal teams to treat Rh-sensitized mothers and their babies is essential.

• #35 Management of Late Anemia in Rhesus Hemolytic Disease: Use of Recombinant Human Erythropoietin (A Pilot Study) | Pediatric Research

  https://www.nature.com/articles/pr19962534

  The management of (Rhesus) hemolytic disease of the fetus and newborn includes intrauterine transfusions to prevent the development of hydrops, treatment of the possible hyperbilirubinemia in the immediate postnatal period, and treatment of late anemia. […] The aim of our study was to test whether recombinant human erythropoietin reduced the need for erythrocyte transfusions in these infants. […] This study demonstrates that recombinant human erythropoietin treatment decreases the need for erythrocyte transfusions in the late anemia of infants with Rh isoimmunization. Considering the risks of blood transfusions, this decrease in the donor exposure is worthwhile. […] rHEPO induces proliferation and differentiation of erythroid progenitors in vitro and has been used in the treatment of anemia of prematurity successfully.

• #36 Management of Late Anemia in Rhesus Hemolytic Disease: Use of Recombinant Human Erythropoietin (A Pilot Study) | Pediatric Research

  https://www.nature.com/articles/pr19962534

  This double blind, placebo-controlled study was planned to investigate whether rHEPO treatment decreased the need for erythrocyte transfusions, that is, treatment of late anemia in Rh isoimmunization. […] Our study was planned as a pilot study only, and therefore the number of cases was low. However, in this double blind, placebo-controlled study, the need for erythrocyte transfusions was significantly reduced in patients receiving rHEPO. […] The administration of rHEPO not only decreases infants’ exposure to multiple blood donors, but also diminishes the need for hospitalization and hence the cost that is involved.

• #37 Haemolytic Disease of the Newborn (HDN) – Milton Keynes University Hospital

  https://www.mkuh.nhs.uk/patient-information-leaflet/haemolytic-disease-of-the-newborn-hdn-2

  Babies severely affected with HDN will need treatment with phototherapy (light treatment) for symptoms of jaundice in the first few days of life until their bilirubin levels are normal. […] Babies with HDN will be prescribed a vitamin called folic acid which helps the body to make new red blood cells. This vitamin is given by mouth daily and continued until the baby is 3 months old.

• #38 Globally, Only Half of Women Get Treatment for Rh Disease | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/globally-only-half-women-get-treatment-preventable-killer-newborns

  A treatment developed over 50 years ago to prevent Rh diseasean often-fatal condition in fetuses and newbornsonly reaches half of the women in the world who need it, according to a study led by researchers at Vagelos College of Physicians and Surgeons (VPS) at Columbia University Irving Medical Center. […] In the 1960s, physicians at VPS developed an immunoprophylaxis therapy, Rh(D) immunoglobulin, that prevents the mother from becoming sensitized to her childs blood cells. […] This treatment is the standard of care for preventing Rh disease, but we recognize that there remain significant obstacles to expanding access to this lifesaving therapy around the world, says Spitalnik, who has been working with an international team of physicians to increase access to therapy with Rh(D) immunoglobulin around the world.

• #39 Globally, Only Half of Women Get Treatment for Rh Disease | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/globally-only-half-women-get-treatment-preventable-killer-newborns

  A variety of factors, including lack of awareness of Rh incompatibility, limited availability of the therapy, and other health care priorities, play a role in hindering access to this life-saving therapy around the world, Spitalnik says. […] To this end, Spitalnik and Brie Stotler, MD, associate professor of pathology cell biology at VPS and co-author of the study, along with an international group of collaborators in obstetrics gynecology, midwifery, pediatrics, neonatology, epidemiology, and transfusion medicine, established Worldwide Initiative Rh Disease Eradication (WIRhE), a nonprofit organization dedicated to improving education about Rh disease and enhancing access to blood type testing and Rh(D) immunoglobulin.

• #40 Dr. Alvin Zipursky devoted his career to eradicating Rh disease and inspired others to continue his work | Professional Education

  https://profedu.blood.ca/en/blog/dr-alvin-zipursky-devoted-his-career-eradicating-rh-disease-and-inspired-others-continue-his

  Currently, all women with an RhD-negative blood type are considered to be at risk for having a baby with Rh disease and are routinely treated with Rh immunoglobulin, even if about 40% of them dont actually need it because their babys blood type is compatible with their own. […] This should not be happeningthis is a condition that is treatable and preventable. […] It was still affecting thousands of women and babies in developing countries. […] Its a worldwide initiativewe need to develop the strategies needed to truly eradicate Rh disease worldwide. […] Rh immunoglobulin is available but mostly in the developed world.

• #41 Globally, Only Half of Women Get Treatment for Rh Disease | Columbia University Irving Medical Center

  https://www.cuimc.columbia.edu/news/globally-only-half-women-get-treatment-preventable-killer-newborns

  A variety of factors, including lack of awareness of Rh incompatibility, limited availability of the therapy, and other health care priorities, play a role in hindering access to this life-saving therapy around the world, Spitalnik says. […] To this end, Spitalnik and Brie Stotler, MD, associate professor of pathology cell biology at VPS and co-author of the study, along with an international group of collaborators in obstetrics gynecology, midwifery, pediatrics, neonatology, epidemiology, and transfusion medicine, established Worldwide Initiative Rh Disease Eradication (WIRhE), a nonprofit organization dedicated to improving education about Rh disease and enhancing access to blood type testing and Rh(D) immunoglobulin.

• #42 Rh Incompatibility Treatment & Management: Prehospital Care, Emergency Department Care

  https://emedicine.medscape.com/article/797150-treatment

  When an infant with Rh incompatibility is delivered in the ED, a more aggressive approach is required, centering on respiratory and hemodynamic stabilization of the infant and determining the need for an emergent exchange transfusion and phototherapy. […] Stress the importance of early prenatal care to each pregnant female who presents to the ED. Early administration of Rh IgG in conjunction with early prenatal care is the best means to prevent Rh incompatibility. […] After administering Rh IgG in the ED, promptly refer the Rh-negative pregnant mother of an Rh-positive fetus to an institution equipped for high-risk obstetric care. […] Refer every pregnant female with Rh incompatibility to a medical center specializing in high-risk obstetric care.

• #43 Rh disease | HealthLink BC

  https://www.healthlinkbc.ca/healthwise/rh-disease

  Treatment for Rh disease depends on how severe the disease is, which can be checked with regular testing throughout the pregnancy. A fetus with mild Rh disease may not need any special treatment. One who is more severely affected may need to have a blood transfusion while still in the uterus and to be delivered early. […] A woman with Rh sensitization is likely to be cared for by a high-risk pregnancy specialist (perinatologist).

• #44 Rh Incompatibility Treatment & Management: Prehospital Care, Emergency Department Care

  https://emedicine.medscape.com/article/797150-treatment

  When an infant with Rh incompatibility is delivered in the ED, a more aggressive approach is required, centering on respiratory and hemodynamic stabilization of the infant and determining the need for an emergent exchange transfusion and phototherapy. […] Stress the importance of early prenatal care to each pregnant female who presents to the ED. Early administration of Rh IgG in conjunction with early prenatal care is the best means to prevent Rh incompatibility. […] After administering Rh IgG in the ED, promptly refer the Rh-negative pregnant mother of an Rh-positive fetus to an institution equipped for high-risk obstetric care. […] Refer every pregnant female with Rh incompatibility to a medical center specializing in high-risk obstetric care.

• #45

  https://www.nhs.uk/conditions/rhesus-disease/

  If an unborn baby does develop rhesus disease, treatment depends on how severe it is. A blood transfusion to the unborn baby may be needed in more severe cases. After delivery, the child is likely to be admitted to a neonatal unit (a hospital unit that specialises in caring for newborn babies). […] Treatment for rhesus disease after delivery can include a light treatment called phototherapy, blood transfusions, and an injection of a solution of antibodies (intravenous immunoglobulin) to prevent red blood cells being destroyed. […] If rhesus disease is left untreated, severe cases can lead to stillbirth. In other cases, it could lead to brain damage, learning difficulties, hearing loss and blindness and vision loss. However, treatment is usually effective and these problems are uncommon.

• #46 Management of neonatal Rh disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8521682/

  Dramatic improvements have been made in the management of Rh disease. Anti-D immune globulin has reduced the incidence of Rh sensitization. Intrauterine transfusions have become routine to treat fetal anemia. […] Once an affected infant is born, several recent improvements in neonatal care have aided in the treatment of hyperbilirubinemia. These include improved phototherapy, such as fiberoptic delivery systems, and intravenous immunoglobulin. Experience with heme oxygenase inhibitors is accumulating, and they may prove efficacious in Rh disease. Double-volume (and perhaps single-volume) exchange transfusion remains an effective method to control hyperbilirubinemia when other therapies fail. Erythropoietin may have a role in treating late, hyporegenerative anemia. Finally, better ways to assess the risk of brain injury in patients with hyperbilirubinemia may become available. Cooperation between the obstetric and neonatal teams to treat Rh-sensitized mothers and their babies is essential.

• #47 Rhesus immunisation in Australia | NHMRCNHMRCNHMRC TaglineNHMRC Tagline

  https://www.nhmrc.gov.au/about-us/resources/impact-case-studies/rhesus-immunisation-australia

  Haemolytic disease of the fetus and newborn (HDFN, also known as Rh Disease) can occur during pregnancy when a pregnant woman’s immune system produces antibodies that attack their fetus’ red blood cells (RBCs). […] Today, HDFN is almost non-existent in Australia due to routine antenatal blood grouping and antibody screening, and the use of prophylactic Rh D immunoglobulin and appropriate clinical management of mother and baby. […] This treatment works by injecting Rh D negative pregnant women with a serum containing ‘passive’ Rh D antibodies (also referred to as anti-D), which inhibit the immune response to Rh D antigens in fetal blood. […] The development of this treatment was the result of an idea by US-based researcher John Gorman and colleagues in 1958. […] From 1966 to 1968, Krieger and obstetrician Geoffrey Bishop oversaw the Australian component of international clinical trials of Rh D immunoglobulin.

• #48 Rhesus pregnancy: immunotherapy to protect the foetus • healthcare-in-europe.com

  https://healthcare-in-europe.com/en/news/rhesus-pregnancy-therapy-protect-foetus.html

  A new study shows that nipocalimab is a good alternative to mitigate the risks of a blood transfusion in a rhesus pregnancy: the drug ensures that the mother’s antibodies can no longer go to the foetus. […] The excellent results of immunotherapy with nipocalimab can therefore be a game changer for the follow-up of women with a rhesus pregnancy. […] A new study show that the drug nipocalimab is a good alternative. […] After treatment with the drug nipocalimab 13 out of the 14 babies survived: a very good result, especially if you know that rhesus disease and the immunity problem usually get worse in ever pregnancy. […] The results of the phase 2 study are encouraging for the phase 3 study that will now be started. […] If the product can be approved after that phase 3 study, it could be the first non-surgical treatment for rhesus pregnancies.

• #49 Medical Management of Rhesus Disease | Article | GLOWM

  https://www.glowm.com/article/heading/vol-16–the-prevention-and-management-of-rh-disease–medical-management-of-rhesus-disease/id/418123

  Fetal red cell destruction by maternal antibodies remains an important cause of fetal and neonatal morbidity and mortality. Intrauterine fetal blood transfusion is the therapy of choice for severe hemolytic disease of the fetus. […] Non-invasive, medical treatments are important to minimize or avoid procedure-related risks. Intravenous immunoglobin (IVIg) and novel monoclonal antibody (M281, nipocalimab) treatments may attenuate the transplacental passage and fetal effects of IgG antibodies. By delaying the onset of fetal anemia, immunological therapies can defer the need for first transfusion. These medical therapies in early onset hemolytic disease of the fetus and newborn (HDFN) improve fetal survival. […] Pregnancies with early-onset fetal anemia (prior to 22 weeks) are the main beneficiaries of medical treatments, which dampen the alloimmune antibody-mediated red cell destruction, as they have the highest rates of procedure-related fetal loss.

• #50 Rhesus immunisation in Australia | NHMRCNHMRCNHMRC TaglineNHMRC Tagline

  https://www.nhmrc.gov.au/about-us/resources/impact-case-studies/rhesus-immunisation-australia

  Haemolytic disease of the fetus and newborn (HDFN, also known as Rh Disease) can occur during pregnancy when a pregnant woman’s immune system produces antibodies that attack their fetus’ red blood cells (RBCs). […] Today, HDFN is almost non-existent in Australia due to routine antenatal blood grouping and antibody screening, and the use of prophylactic Rh D immunoglobulin and appropriate clinical management of mother and baby. […] This treatment works by injecting Rh D negative pregnant women with a serum containing ‘passive’ Rh D antibodies (also referred to as anti-D), which inhibit the immune response to Rh D antigens in fetal blood. […] The development of this treatment was the result of an idea by US-based researcher John Gorman and colleagues in 1958. […] From 1966 to 1968, Krieger and obstetrician Geoffrey Bishop oversaw the Australian component of international clinical trials of Rh D immunoglobulin.

• #51 Rhesus immunisation in Australia | NHMRCNHMRCNHMRC TaglineNHMRC Tagline

  https://www.nhmrc.gov.au/about-us/resources/impact-case-studies/rhesus-immunisation-australia

  They concluded that Rh D immunoglobulin was an effective prophylaxis (preventative measure) against HDFN and could reduce – and possibly eliminate – this disease. […] In 1969, Australia became the first country to offer free Rh D immunoglobulin to all pregnant Rh D negative women at risk of HDFN. […] In 2021, the NBA and the Royal Australian College of Obstetricians and Gynaecologists released a new evidence-based guideline: the Guideline for the prophylactic use of Rh D immunoglobulin in pregnancy care. […] Today, approximately 17% of women in Australia who become pregnant require Rh D immunoglobulin injections to prevent Rh disease and ensure their baby’s health. […] Clinical incidence of HDFN is almost non-existent in Australia due to the discovery of Rh D immunoglobulin in conjunction with routine antenatal screening for Rh blood groups and appropriate management of mother and baby. […] Following a systematic review of evidence and consensus by a multidisciplinary committee, NIPT for fetal RHD blood group genotype for all Rh D negative pregnancies in Australia was recommended in the Guideline for the prophylactic use of Rh D immunoglobulin in pregnancy care.

• #52 Management of neonatal Rh disease – PubMed

  https://pubmed.ncbi.nlm.nih.gov/8521682/

  Dramatic improvements have been made in the management of Rh disease. Anti-D immune globulin has reduced the incidence of Rh sensitization. Intrauterine transfusions have become routine to treat fetal anemia. […] Once an affected infant is born, several recent improvements in neonatal care have aided in the treatment of hyperbilirubinemia. These include improved phototherapy, such as fiberoptic delivery systems, and intravenous immunoglobulin. Experience with heme oxygenase inhibitors is accumulating, and they may prove efficacious in Rh disease. Double-volume (and perhaps single-volume) exchange transfusion remains an effective method to control hyperbilirubinemia when other therapies fail. Erythropoietin may have a role in treating late, hyporegenerative anemia. Finally, better ways to assess the risk of brain injury in patients with hyperbilirubinemia may become available. Cooperation between the obstetric and neonatal teams to treat Rh-sensitized mothers and their babies is essential.

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