Rhesus incompatibility Management

Incompatibility between an infant’s blood type and that of its mother, resulting in destruction of the infant’s red blood cells (haemolytic anaemia) during pregnancy and after birth by antibodies from the mother’s circulation.

Investigations

• Maternal blood group and rhesus factor

• Paternal blood group and rhesus factor

• Infant cord blood at delivery for grouping, full blood count, Coombs test to detect maternal antibodies, and total bilirubin

Prevention of rhesus isoimmunisation

If the mother is rhesus negative:

• Anti-D immunoglobulin 300 micrograms within 72 hours of delivery

Antepartum prophylaxis

• Anti-D immunoglobulin (IM) at 28–32 weeks of gestation

After abortion in rhesus negative mother

• Anti-D immunoglobulin 100 micrograms (IM) within 72 hours of abortion

Note

For the management of other medical conditions in pregnancy such as malaria, peripartum cardiomyopathy, diabetes, and renal disease in pregnancy, refer to specific chapters in this guideline.