Isoimmunization in Pregnancy: Mechanism, Prevention, Complications, Diagnosis, and Management

Mechanism of Isoimmunization in Pregnancy

Isoimmunization occurs when a pregnant woman's immune system produces antibodies against fetal red blood cells due to an incompatibility between maternal and fetal blood groups. This can happen when fetal red blood cells enter maternal circulation, typically due to trauma, invasive procedures, or during childbirth.

Prevention

• Routine screening for blood group incompatibility.
• Administration of Rh immunoglobulin (RhIG) to Rh-negative mothers.
• Minimizing fetal-maternal hemorrhage during procedures.

Complications

If untreated, isoimmunization can lead to hemolytic disease of the fetus and newborn (HDFN), causing severe anemia, jaundice, heart failure, and hydrops fetalis.

Diagnosis

Diagnosis involves serological testing for maternal antibodies, Doppler ultrasound for fetal anemia, and amniocentesis if necessary.

Management

• Close monitoring of maternal antibody titers.
• Intrauterine transfusion for severe fetal anemia.
• Early delivery if fetal distress is detected.