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Case Reports
. 2015 Dec;8(4):193-4.
doi: 10.1177/1753495X15597631. Epub 2015 Aug 21.

Rare problems with RhD immunoglobulin for postnatal prophylaxis after large fetomaternal haemorrhage

Amber Biscoe  1 , Giselle Kidson-Gerber  2
Affiliations
Case Reports

Rare problems with RhD immunoglobulin for postnatal prophylaxis after large fetomaternal haemorrhage

Amber Biscoe et al. Obstet Med. 2015 Dec.

Abstract

We report a case of unusually large fetomaternal haemorrhage in a RhD- patient; of symptomatic non-sustained haemolysis of fetal red cells in the maternal circulation with infusion of intravenous high-dose RhD immunoglobulin; and of a failure to prevent RhD alloimmunisation. The haemolytic reaction is not previously reported in this patient group and we suggest would be limited to patients where the number of fetal red cells in the circulation is high. We advocate caution in treatment and spaced dosing of RhD immunoglobulin where the required dose is high, and refer readers to the WinRhoSDF™ RhD immunoglobulin product information for their updated dosing recommendations. There is a need for better understanding of pathophysiology and RhD immunoglobulin effects, to further reduce alloimmunisation rates, and we support the reporting of prophylaxis failures to haemovigilance programmes as is in place in the United Kingdom.

Keywords: Haematology; haemorrhage; maternal–fetal medicine; perinatal medicine.

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