Hemolytic disease of the newborn - Supervision of pregnant women with Rh negative

1. The first visit will be a pregnant phenotypic and RH blood group and indirect Coombs test.
If you have Rh negative pregnant is taken for transfusion history and evolution of other tasks. Will be more accurate evaluation of pregnancy.

2. For pregnant women with Rh negative without antibodies
- Repeat antibodies to V.G. 28 weeks:
a) if the test is negative Coombs anti D immunoglobulin is administered both at 28 weeks, and within 72 hours after birth;
b) if the test is positive Coombs serial dosing of antibodies are possibly amniocentesisand ultrasound to measure the fetal biliamniei.

3. For pregnant women with Rh negative first pregnancy with anti D
a. If the antibody is less than 1 / 16 (critical threshold) - the prognosis is good - repeatevery 2-3 weeks antibodies (to detect sudden increases) - leave pregnancy to term.
b. If the antibody is ≥ than the critical threshold:
- Aims to level the amniocenteze biliamniei repeated at 28 weeks;
If IO450 is low, repeat every 3-4 weeks biliamnia;
If IO450 is elevated, biliamnia repeated every 1-2 weeks;
- Aims to condition of the fetus by ultrasound.

4. For pregnant Rh negative immunized with the following tasks
- If anti Rh low titre and increased sharply initially, the fetus is Rh positive;
- There are no antibody titration, it follows biliamnia from 28 weeks or earlier if theantibody is very large and busy history.
Amniocentezelor interval is 2-3 weeks if biliamnia is low and 1-2 weeks if the values ​​are increased.