What constitutes the most cautious approach for a pregnant person with weak D type 4.0?

Flegel, Willy A.; Bodnar, Melanie; Clarke, Gwen; Hannon, Judith; Lieberman, Lani

doi:10.1503/cmaj.78986

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…However, pregnant mothers with molecularly defined weak D 1, 2, 3, 4.0, and 4.1 do not require RhIG. Notably, in many European countries and the United States, in cases where the genotype of the pregnant mother is determined as weak D types 1, 2, 3, 4.0, or 4.1, RhIG is not administered [5,[29][30][31][32]. Those with other weak D subtypes require RhIG.…”

Section: Rhig In Women With D Variantsmentioning

confidence: 99%

Guide to Rho(D) Immune Globulin in Women With Molecularly Defined Asian-type DEL (c.1227G>A)

Jeong,

Yu,

Kim

et al. 2024

Ann Lab Med

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Rh hemolytic disease of the fetus and newborn is a potential risk for D-negative mothers who produce anti-D during pregnancy, which can lead to morbidity and mortality in subsequent pregnancies. To prevent this hemolytic disease, Rho(D) immune globulin (RhIG) is generally administered to D-negative mothers without anti-D at 28 weeks of gestation and shortly after delivery. However, current guidelines suggest that pregnant mothers with molecularly defined weak D types 1, 2, 3, 4.0, and 4.1 do not need RhIG as they are unlikely to produce alloanti-D when exposed to fetuses with D-positive red cells. This issue and the necessity of RHD genotyping have been extensively discussed in Western countries, where these variants are relatively common. Recent evidence indicates that women with Asian-type DEL (c.1227G>A) also do not form alloanti-D when exposed to D-positive red cells. We report that mothers with molecularly defined Asian-type DEL, similar to those with weak D types 1, 2, 3, 4.0, and 4.1, do not require RhIG before and after delivery. Collectively, this review could pave the way for the revision of international guidelines to include the selective use of RhIG based on specific genotypes, particularly in women with the Asian-type DEL.

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Section: Rhig In Women With D Variantsmentioning

confidence: 99%