RhD isoimmunization and current management modalities.
OBJECTIVE
To review the literature on current perspectives and treatment of RhD isoimmunization.


METHODS
A search was conducted on MEDLINE and CINAHL, and supplemental articles/ bulletins were obtained from cited references and the Web site of the American College of Obstetricians and Gynecologists. Recent texts also were reviewed. Key search words: isoimmunization, Rho (d) immune globulin, fetal erythroblastosis, intrauterine blood transfusions, alloimmunization.


METHODS
Articles and comprehensive works from indexed journals in the English language relevant to key words and published after 1995 were evaluated. Historically relevant periodicals and texts were also reviewed and selected.


METHODS
Data were extracted and organized under the following headings: testing of the antepartum patient, antepartum treatment of isoimmunization, testing of the postpartum patient, anti-D immune globulin, antepartum anti-D immune globulin prophylaxis, other antepartum and obstetric indications for anti-D immune globulin administration, postpartum anti-D immune globulin prophylaxis, nursing implications, and future possibilities.


RESULTS
RhD isoimmunized pregnancies continue to contribute to worldwide perinatal and neonatal morbidity and mortality. This review describes the basic knowledge necessary to care for these pregnancies and the current management modalities.


CONCLUSIONS
The management options for RhD compromised gestations continue to evolve almost as quickly as technological advances are made. Multiple areas of research in this field have surfaced, and nurses can become valuable members of these research teams. The literature also indicates that with the available knowledge and resources, the current rate of RhD isoimmunization can be further decreased with closer adherence to proposed management guidelines by all health care professionals.
Neal
J L
JL
The Ohio State University, Columbus, USA. neal.167@osu.edu
D005260:Female; D005544:Forecasting; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000379:methods / Q000639:trends; D016389:Maternal-Child Nursing / Q000379:methods / Q000639:trends; D011181:Postnatal Care / Q000379:methods / Q000639:trends; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D011295:Prenatal Care / Q000379:methods / Q000639:trends; D011296:Prenatal Diagnosis / Q000379:methods / Q000639:trends; D012203:Rh Isoimmunization / Q000175:diagnosis* / Q000453:epidemiology / Q000276:immunology / Q000628:therapy*; D012204:Rh-Hr Blood-Group System / Q000276:immunology; D018029:Rho(D) Immune Globulin / Q000276:immunology / Q000627:therapeutic use
D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin