Clinical profile and fetomaternal outcome of Rh-negative pregnancy: A retrospective observational study

Background: Rh incompatibility remains an important cause of preventable perinatal morbidity and mortality. Despite widespread availability of anti-D immunoglobulin, Rh isoimmunization continues to be encountered in clinical practice, particularly in developing countries. Objectives: To study the clinical profile of Rh-negative pregnant women and to assess fetomaternal outcomes associated with Rh-negative pregnancy. Methods: This retrospective observational study was conducted at Shri Atal Bihari Vajpayee medical college and reseach institute, Bengaluru, over a period of 12months (November2023 to November 2024). Rh-negative pregnant women fulfilling the inclusion criteria were analyzed for demographic details, obstetric history, indirect Coombs test (ICT) status, antibody titers, Doppler findings, anti-D immunoglobulin administration, mode of delivery, and neonatal outcomes. Results: Thirty Rh-negative pregnant women were included. Ten (33%) were primigravida and twenty (67%) were multigravida. Six women (20%) were ICT positive. One woman was sensitized during her first pregnancy (grandmother theory). One patient developed severe fetal anemia requiring three cycles of intrauterine transfusion, and one presented with fetal hydrops. Sixteen women (53%) underwent lower segment cesarean section for fetomaternal indications. Neonatal morbidity was higher among isoimmunized pregnancies. Conclusion: Although anti-D immunoprophylaxis has significantly reduced Rh isoimmunization, it has not eliminated it. Early detection, appropriate prophylaxis, and timely fetal surveillance and intervention are essential to improve perinatal outcomes.