How to treat Rh incompatibility during pregnancy?

Question

Hello doctor,

My wife has an Rh-negative blood group, while I have an O-positive blood group. Unfortunately, she experienced two miscarriages, one at nine months due to oligohydramnios and the other at seven months due to hydrops fetalis. Anti-D (Rh immunoglobulin) was administered after both deliveries. Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I can understand your concern.

It must have been incredibly challenging for both you and your wife.

Addressing Rh-related complications depends on their severity. Your wife needs to undergo prenatal assessments before any subsequent pregnancies. Considering the previous occurrence of hydrops in a pregnancy, there are several options to consider:

In settings where facilities exist to determine the baby's blood group in the first or early second trimester, this information can guide management. If the baby is Rh-negative, that is positive news. However, if the baby is Rh-positive, options including discussions about potential therapeutic abortion would be considered involving both you and your wife.

In situations where there are no facilities to determine the baby's blood group during pregnancy, monitoring the pregnancy becomes essential. The goal is to assess the severity of rhesus isoimmunization during pregnancy and aim to carry it as close to term as possible before delivery.

It is important to note that even if fetal hydrops have occurred before, there remains a risk of recurrence if your wife carries an Rh-positive child.

I hope this information will help you.

Thank you.