Management of Rhesus Isoimmunized Pregnant Woman in Low Resource Setting: A Case Report

Rh isoimmunization of pregnant mothers may be responsible for varying severity of anaemia in fetuses and newborns. Usually, it is in the second or subsequent pregnancies that the fetus is affected. Management of this patient in a low resource setting posed serious challenges as various interventions levels. A 28-year-old G6P5+0 1alive at 17weeks of gestation, in her six pregnancy who had developed Anti-D antibodies after her first pregnancy. pregnancy was unbooked, carried to term and had spontaneous vaginal delivery at home to a live female neonate. She was unaware of her blood group and Rhesus typing and did not received Anti-D immunoglobulin. Subsequently, she had recurrent intrauterine stillbirth and early neonatal death. Current pregnancy was carried to 31weeks of gestation when it was noticed the fetus had severe anaemia following evaluation with middle cerebral artery-peak systolic velocity and had Caeserean section. The neonate had exchange blood transfusion and phototherapy following delivery. Close fetal monitoring with middle cerebral artery- peak systolic velocity and timely delivery can lead to a favorable outcome in low resource setting