Pregnancy

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Rh isoimmunization, blood group incompatibility

Australia

• National Blood Authority
  • Guideline for the prophylactic use of Rh D immunoglobulin in pregnancy care

• National Health and Medical Research Council
  • Rhesus immunisation in Australia

• NSW Health
  • Maternity - Rh (D) Immunoglobulin (Anti D)

• Queensland Health
  • Rh D negative women and pregnancy (guideline supplement)
  • Rh D negative women and pregnancy

• SA Health
  • Anti-D Prophylaxis

Australia, New Zealand

• Australian & New Zealand Society of Blood Transfusion
  • Guidance for RHD non invasive prenatal testing (RHD NIPT) for fetal RhD blood group prediction in pregnancy [2023]
  • Guidelines for the Laboratory Estimation of Fetomaternal Haemorrhage [2021]

• Royal Australian and New Zealand College of Obstetricians and Gynaecologists
  • Guidelines for the use of Rh(D) Immunoglobulin (Anti-D) in obstetrics [2023]

Canada

• British Journal of Haematology
  • Laboratory assessment of fetomaternal haemorrhage and Rh immune globulin management: Canadian practice and scoping review [2025]

• Canadian Family Physician
  • Approach to red blood cell antibody testing during pregnancy: Answers to commonly asked questions [2020]

• Journal of Obstetrics and Gynaecology Canada
  • Transfusion Testing During Routine Pregnancies: Consensus Recommendations from a Modified Delphi Process [2025]
  • National Consensus Statements for the Prevention of Maternal Rhesus D Alloimmunization and Management of Alloimmunized Pregnancies: A Modified Delphi Process [2025]

• National Advisory Committee on Blood and Blood Products
  • NAC Endorsement with Caveats: International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn [2024]
  • RHD Genotyping in Prenatal Patients
  • NAC Position Paper: Utilization and Inventory Management of Group O RH(D)- Negative Red Cells

• Ontario Health
  • Noninvasive Fetal RhD Blood Group Genotyping: A Health Technology Assessment [2020]

• Perinatal Services BC
  • Red Blood Cell Antigens

• Society of Obstetricians and Gynaecologists of Canada
  • SOGC Statement on Rh and Alloimmunization [2025]
  • Prevention of Rh D Alloimmunization [2024]
  • Routine Non-invasive Prenatal Prediction of Fetal RHD Genotype in Canada: The Time is Here [2017]

China

• Journal of Translational Medicine
  • DEL in China: the D antigen among serologic RhD-negative individuals [2021]

Colombia

• Revista Colombiana de Obstetricia y Ginecología
  • Colombian consensus for the diagnosis, prevention, and management of Rhesus disease [2024]

Europe

• ISBT Science Series
  • Rh disease prevention: the European Perspective [2021]

Finland

• Acta Obstetricia et Gynecologica Scandinavica
  • Time points and risk factors for RhD immunizations after the implementation of targeted routine antenatal anti-D prophylaxis: A retrospective nationwide cohort study [2022]

France

• BMC Pregnancy and Childbirth
  • Effectiveness and costs of non-invasive foetal RHD genotyping in rhesus-D negative mothers: a French multicentric two-arm study of 850 women [2018]

• Collège National des Gynécologues et Obstétriciens Français
  • Prevention of RhD alloimmunization in the first trimester of pregnancy: Clinical practice guidelines of the French College of Obstetricians and Gynecologists [2025]

India

• Federation of Obstetric and Gynecological Societies of India
  • Anti-D Immunoglobulin for Rh Prophylaxis: Key Practice Points [2022]

International

• BMC Pregnancy and Childbirth
  • Patient experience and burden of haemolytic disease of the foetus and newborn: a systematic review [2025]
  • Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape [2023]
  • Targeted antenatal anti-D prophylaxis for RhD-negative pregnant women: a systematic review [2020]
  • Appropriate provision of anti-D prophylaxis to RhD negative pregnant women: a scoping review [2014]

• European Journal of Contraception & Reproductive Health Care
  • Management of anti-D prophylaxis in RhD negative women undergoing early medical abortion - an international practice survey among practitioners [2025]

• International Collaboration for Transfusion Medicine Guidelines
  • International guidelines regarding the role of IVIG in the management of Rh- and ABO-mediated haemolytic disease of the newborn [2022]

• International Federation of Gynecology and Obstetrics
  • FIGO/ICM guidelines for preventing Rhesus disease: A call to action [2021]

• JAMA Network Open
  • Variations and Opportunities in Postnatal Management of Hemolytic Disease of the Fetus and Newborn [2025]

• Pediatric Research
  • Neonatal hyperbilirubinemia and Rhesus disease of the newborn: incidence and impairment estimates for 2010 at regional and global levels [2013]

• PLoS ONE
  • Hemolytic disease of the fetus and newborn due to Rh(D) incompatibility: A preventable disease that still produces significant morbidity and mortality in children [2020]
  • Antenatal and postpartum prevention of Rh alloimmunization: A systematic review and GRADE analysis [2020]

• Revista Brasileira de Ginecologia e Obstetrícia
  • Non-RhD alloimmunization in pregnancy: an updated review [2024]

Italy

• Società Italiana di Medicina Trasfusionale e Immunoematologia
  • Recommendations for the prevention and treatment of haemolytic disease of the foetus and newborn [2015]
  • Survey on the prevention and incidence of haemolytic disease of the newborn in Italy [2013]

Latin America

• BMC Pregnancy and Childbirth
  • Hemolytic disease of the fetus and newborn and Rhesus alloimmunization in Latin American countries: a scoping review [2024]

Mexico

• Blood Transfusion
  • Rh disease in Mexico: evaluating regional and institutional differences in treatment availability and disease management [2025]

Netherlands

• BJOG: An International Journal of Obstetrics & Gynaecology
  • Risk factors for RhD immunisation in a high coverage prevention programme of antenatal and postnatal RhIg: a nationwide cohort study [2022]

• BMJ
  • Sensitivity of fetal RHD screening for safe guidance of targeted anti-D immunoglobulin prophylaxis: prospective cohort study of a nationwide programme in the Netherlands [2016]

• Transfusion
  • Reduction of anti-K-mediated hemolytic disease of newborns after the introduction of a matched transfusion policy: A nation-wide policy change evaluation study in the Netherlands [2021]

New Zealand

• New Zealand Blood Service
  • Intrauterine Transfusion (IUT)
  • Haemolytic Disease of the Fetus and Newborn (HDFN)

• Starship
  • Hydrops fetalis

Norway

• Acta Obstetricia et Gynecologica Scandinavica
  • Following targeted routine antenatal anti-D prophylaxis, almost half of the pregnant women had undetectable anti-D prophylaxis at delivery [2022]

• Fetal Diagnosis and Therapy
  • Terminating Routine Cord Blood RhD Typing of the Newborns to Guide Postnatal Anti-D Immunoglobulin Prophylaxis Based on the Results of Fetal RHD Genotyping [2023]

Republic of Korea

• Annals of Laboratory Medicine
  • Guide to Rho(D) Immune Globulin in Women With Molecularly Defined Asian-type DEL (c.1227G>A) [2024]

South Africa

• National Department of Health South Africa
  • Recommendations for Restricted Use of Anti-D Immunoglobulin [2021]

• South African Society of Obstetricians and Gynaecologists
  • Rh Disease and Alloimmunisation [2022]

United Kingdom

• BMC Pregnancy and Childbirth
  • Routine administration of Anti-D: the ethical case for offering pregnant women fetal RHD genotyping and a review of policy and practice [2014]

• British Society for Haematology
  • Guideline for blood grouping and red cell antibody testing in pregnancy [2016]
  • BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn [2014]
  • Guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn

• Health Technology Assessment
  • High-throughput non-invasive prenatal testing for fetal rhesus D status in RhD-negative women not known to be sensitised to the RhD antigen: a systematic review and economic evaluation [2018]

• National Institute for Health and Care Excellence
  • High-throughput non-invasive prenatal testing for fetal RHD genotype [2016]
  • Routine antenatal anti-D prophylaxis for women who are rhesus D negative [2008]

• NHS England
  • Management of fetal anaemia secondary to red cell alloimmunisation [2015]

• Royal College of Obstetricians and Gynaecologists
  • The Use of Novel Therapies in the Management of Haemolytic Disease of the Fetus and Newborn [2024]
  • The Management of Women with Red Cell Antibodies during Pregnancy [2014]

• Transfusion Medicine
  • Implementation of high-throughput non-invasive prenatal testing for fetal RHD genotype testing in England: Results of a cross-sectional survey of maternity units and expert interviews [2020]

• UK National Screening Committee
  • Blood group & RhD status and red cell alloantibodies

• WISDOM
  • Management of Rhesus Negative Women in Pregnancy [2025]
  • Guidelines for Anti D [2023]

United States

• American College of Obstetricians and Gynecologists
  • Rho(D) Immune Globulin Shortages [2024]
  • Practice Bulletin No. 181: Prevention of Rh D Alloimmunization [2017]

• Archives of Pathology & Laboratory Medicine
  • Obstetric and Newborn Weak D-Phenotype RBC Testing and Rh Immune Globulin Management Recommendations: Lessons From a Blinded Specimen-Testing Survey of 81 Transfusion Services [2023]

• Association for the Advancement of Blood & Biotherapies
  • Use of Rh Immune Globulin and Considerations in the Setting of Supply Shortages and Limited Availability [2024]

• College of American Pathologists
  • Use of Fetal Hemoglobin Quantitation for Rh-Positive Pregnant Females: A National Survey and Review of the Literature [2019]
  • It's time to phase in RHD genotyping for patients with a serologic weak D phenotype. College of American Pathologists Transfusion Medicine Resource Committee Work Group [2015]

• Contraception
  • Economic analysis of foregoing Rh immunoglobulin for bleeding in pregnancy <12 weeks gestation [2024]

• JAMA
  • Induced Abortion and the Risk of Rh Sensitization [2023]

• JAMA Network Open
  • A Clinical Practice Guideline for the Management of Pregnancy Alloimmunized to Red Blood Cell Antigens [2025]

• Obstetrics & Gynecology
  • Standard Compared With Extended Red Blood Cell Antigen Matching for Prevention of Subsequent Hemolytic Disease of the Fetus and Newborn: A Systematic Review [2025]
  • Clinical Performance of Cell-Free DNA for Fetal RhD Detection in RhD-Negative Pregnant Individuals in the United States [2025]

• Society for Maternal-Fetal Medicine
  • Society for Maternal-Fetal Medicine Statement: RhD immune globulin after spontaneous or induced abortion at less than 12 weeks of gestation [2024]
  • Society for Maternal-Fetal Medicine (SMFM) Clinical Guideline #8: The fetus at risk for anemia–diagnosis and management [2015]

• Society of Family Planning
  • Society of Family Planning committee consensus on Rh testing in early pregnancy [2022]

• Transfusion
  • It’s time to phase-in RHD genotyping for patients with a serological weak D phenotype [2014]

• U.S. Preventive Services Task Force
  • Rh(D) Incompatibility: Screening [2004]

Western countries

• PLoS ONE
  • Clinical value of different anti-D immunoglobulin strategies for preventing Rh hemolytic disease of the fetus and newborn: A network meta-analysis [2020]

WHO

• World Health Organization
  • Clinical services Recommendation 8: Rh isoimmunization for abortion at gestational ages < 12 weeks (3.3.3) [2022]

{Related topics}

• Topic
  • Prenatal screening and diagnosis
  • Obstetrics, perinatology
  • Neonatal hematologic disorders