EC Gynaecology

Background: Rh-negative pregnancies represent a significant clinical concern due to the potential for Rh alloimmunization, a condition that can lead to various neonatal complications. Prevalence of Rh negative pregnancy in Western countries is 15%, but in India it varies from 3% to 8%. It can lead to perinatal loss of 1 to 2.5%. The objective of our study is to assess the fetomaternal outcomes in Rh negative pregnancies in our institution.

Materials and Methods: This prospective observational study was conducted at the Department of Obstetrics and Gynaecology, ESIC Medical College and Post Graduate Institute of Medical Sciences and Research, Rajajinagar, Bangalore from April 2023 to October 2024 involving 200 Rh negative women. Fetal outcomes like blood group, bilirubin levels, hemoglobin, NICU admissions, exchange transfusions, phototherapy and maternal outcomes like age, gravida, mode of deliveries, Rh anti D Ig status, indications of caesarean section and associated comorbidities were assessed.

Results: Mean age of the women was 26 years, with 120 being multigravida and 80 primigravida. 57.5% of them underwent LSCS and rest delivered vaginally. 165 women delivered Rh positive fetus. Only 12 patients received antenatal anti D with ICT being positive in 5 cases of which one was hydrops fetalis, 4 were fetal anemia requiring exchange transfusions and one baby also requiring phototherapy for hyperbilirubinemia.

Conclusion: In our study, no adverse outcomes were seen in primigravida whereas multigravida without anti D administration in previous pregnancies had outcomes like hydrops fetalis, fetal anemia and hyperbilirubinemia leading to neonatal morbidity indicating need for promoting awareness about anti D in all Rh negative pregnant women right from their first antenatal visit.

 Keywords: Rh Isoimmunisation; Anti D; Sensitization; Hydrops Fetalis; Exchange Transfusion; Phototherapy

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