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Rhesus disease: postnatal management and outcome
1Children Nationwide Regional Neonatal Intensive Care Centre, King's College Hospital, London, UK. anne.greenough@kcl.ac.uk
European Journal of Pediatrics
|September 15, 1999
Summary
Rhesus haemolytic disease incidence has decreased, with fewer infants needing hyperbilirubinaemia treatment. Long-term outcomes for affected infants remain largely unknown, necessitating further research.
Area of Science:
- Neonatal Medicine
- Hematology
- Pediatrics
Background:
- Significant reduction in the incidence of rhesus haemolytic disease observed.
- Intrauterine transfusions in affected infants can lead to late hyporegenerative anaemia.
- Postnatal haemolysis and hyperbilirubinaemia treatment needs are reduced.
Purpose of the Study:
- To review the current management and outcomes of infants with rhesus haemolytic disease.
- To identify areas for further research and improvement in clinical strategies.
- To highlight the need for data on long-term prognosis.
Main Methods:
- Review of current clinical practices and outcomes.
- Analysis of treatment efficacies, including phototherapy and potential inhibitors.
- Assessment of mortality and morbidity rates, including bilirubin encephalopathy.
Main Results:
- Optimal phototherapy decreases the need for postnatal exchange transfusions.
- Mortality for hydropic infants is below 20%; bilirubin encephalopathy is uncommon.
- Efficacy data for bilirubin production inhibitors (e.g., haem oxygenase inhibitors, immunoglobulin) are less secure.
Conclusions:
- While immediate outcomes have improved, long-term follow-up data for infants with rhesus haemolytic disease is limited.
- Multicentre collaboration is essential to further refine management strategies.
- Further research is required to provide meaningful data on the long-term prognosis of these individuals.