MATERNAL AND FETAL OUTCOME IN RH NEGATIVE PREGNANCY

Abstract

INTRODUCTION- When Rh negative maternal blood is exposed to Rh positive fetal blood (RBC) in maternal circulation, antibodies against Rh (D) may develop in the mother. These Rh (D) antibody, once produced, remains in the woman's circulation and poses the threat of hemolytic disease (due to destruction of fetal RBCs ) for subsequent Rh-positive fetuses and this event leads to alloimmunization. Coombs test is the most common method to detect alloimmunization done during pregnancy (ICT) and in postnatal period (DCT). Rhesus (Rh) isoimmunization is an important clinical entity in India and other developing countries, which is responsible for fetal anemia and hydrops fetalis, and if not treated, it can result in intrauterine fetal demise, thus timely diagnosis follow-up and management of Rh –ve pregnancy is must. MATERIAL AND METHODS- st th This is a retrospective observational study, done in a private hospital, Gwalior (M.P.), form 1 Jan. 2018 to 30 June 2020. 88 women with Rh-ve pregnancy were studied during this period, Data was recovered from labor room record, OT, PNC, post operative wards for maternal outcome a SNCU for neonatal outcome. RESULTS- In our study the most common age group was 21-25 years (62.5%), most of the patient were Primigravida(42.4%), most of them were unbooked (65.90%) and from Rural area (72.72%). The most common blood group Rh- was o-ve (53.40%). Only 2 patients had positive indirect coombs test. Most of the patients delivered normally, only (28.40%)Patients delivered by LSCS. Preeclampsia was the most common maternal complication found in Rh- Patient (12.5%). 96.59% of Neonates were live born. 2.27% were fresh still born and 1.13% were macerated still born. 24 babies were admitted in SNCU. The most common cause of admission was neonatal jaundice (66.66%). The most (76.13%) of the babies had serum bilirubin level between 10-15 mg/dl. CONCLUSION- We concluded that Rh isoimmunization leads to increased perinatal morbidity for perinatal morbidity. The obstetrician and maternity staff should be familiar to diagnosis and management of with Rhesus incompatibility and they should counsel the Rh negative patient about Importance of checking blood group and Rh type in pregnancy and should educated them about importance of Rh prophylaxis and Hemolytic diseases of fetus and newborn risks of present and future pregnancy. During past few decades there had been major advances in the medical treatment for Rh negative pregnancy.