RH INCOMPATIBILITY AS A CURRENT PROBLEM IN MODERN OBSTETRICS

Abstract

Rh incompatibility remains one of the current challenges in modern obstetrics and perinatology, as it may lead to the development of Hemolytic disease of the fetus and newborn, intrauterine hypoxia, hydrops fetalis, and severe perinatal complications, including fetal death. Despite significant progress in the prevention of Rh alloimmunization, this condition continues to be clinically relevant due to delayed diagnosis, insufficient prophylactic coverage, and the complexity of managing sensitized pregnancies.

The article analyzes contemporary approaches to the prevention, diagnosis, and management of pregnant women at risk of Rh alloimmunization. The main pathogenetic mechanisms of Rh incompatibility, risk factors for maternal sensitization, and the role of the maternal immune response in the development of fetal hemolytic anemia are discussed. Particular attention is paid to modern methods of prenatal diagnosis, including determination of anti-D antibody titers, ultrasonography, Doppler assessment of the fetal middle cerebral artery, and noninvasive fetal RhD genotyping using analysis of cell-free fetal DNA in maternal blood.

The study emphasizes the importance of timely fetal monitoring for early detection of hemolytic anemia and prevention of severe forms of fetal hemolytic disease. It is highlighted that the timely administration of anti-D immunoglobulin during pregnancy and after delivery remains the most effective method for preventing Rh alloimmunization. The implementation of modern preventive protocols, improvement of molecular genetic diagnostic methods, and a personalized approach to pregnancy management contribute to reducing severe perinatal complications and improving perinatal outcomes.

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