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CC BY-NC-ND 4.0 · AJP Rep 2024; 14(03): e228-e230
DOI: 10.1055/s-0044-1791525
Case Report

Anti-D Alloimmunization in Index Pregnancy after Appropriate Rho(D) Immune Globulin Injection in Two Obese Rh-Negative Patients

Stephanie Rodriguez 
1   Department of Maternal Fetal Medicine, Loyola University Medical Center, Illinois
,
Phillip J. DeChristopher
2   Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Illinois
,
Kristen Krum
2   Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Illinois
,
Ann Lal
1   Department of Maternal Fetal Medicine, Loyola University Medical Center, Illinois
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Abstract

Background The rhesus factor D (RhD)-negative patients who give birth to an RhD-positive newborn or who are otherwise exposed to RhD-positive red blood cells are at risk of developing anti-D antibodies. These antibodies may cause hemolytic disease of the fetus and newborn (HDFN). During pregnancy, prevention of alloimmunization is completed with a Rho(D) immune globulin (RhIg).

Cases We report two cases, where obese patients developed alloimmunization, with high neonatal titers, after appropriate RhIG prophylaxis during the index pregnancy.

Conclusion Our cases demonstrate cases of anti D-alloimmunization in an index pregnancy, with high neonatal titers. Both patients are obese, with BMI > 35 mg/m2.

Key Points

  • RhIG can be administered via intramuscular or intravenous formulations. Overall, it appears that both formulations are equally effective. The optimal administration, especially with obese women, is not clearly established.

  • Our cases demonstrate that obesity is a risk factor for failure of RhIG, and could lead to an increase in HDFN.

Keywords

alloimmunization - Rh negative - hemolytic disease of the fetus and newborn - anti-D antibodies - Rhophylac - RhIG


Publikationsverlauf

Eingereicht: 14. Juni 2024

Angenommen: 25. August 2024

Artikel online veröffentlicht:
30. September 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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