Successful Management of Early Onset Rh-immunized Pregnancy

Abstract

ABSTRACT Rh-isoimmunization still remains an important preventable cause of perinatal mortality and morbidity. The improved perinatal outcome in sensitized patients is mainly attributed to application of color Doppler ultrasonography as a noninvasive method of detecting and monitoring fetal anemia and fetal wellbeing, improvement in ultrasonography machines and fetal interventional techniques and better neonatal intensive care facilities. Here, we present a case G3P2L1D, Rh negative with previous lower segment cesarean section (LSCS), diagnosed to be indirect Coomb's test (ICT) positive (1:64) at 9 weeks. She was followed up with serial ICT titers every 2 weeks along with ultrasonography (USG) and Doppler. Fetal anemia was detected with middle cerebral artery (MCA) Doppler at 27 weeks and same treated with intrauterine transfusions twice. She was diagnosed to have gestational diabetes mellitus and treated for the same. Patient then delivered at 36 weeks and 5 days by emergency LSCS in labor, a healthy girl baby, 3.07 Kg. Postnatally, baby developed jaundice and was treated with double light phototherapy. Baby also developed anemia subsequently 3 days after birth and was treated with one dose of intravenous (IV) immunoglobulin. Baby with mother were discharged on postoperative day 5 in good health. How to cite this article Vasanthalakshmi GN, Sirisha, Pushpalatha. Successful Management of Early Onset Rhimmunized Pregnancy. J South Asian Feder Obst Gynae 2015;7(3):202-204.