Tropical Journal of Obstetrics and Gynaecology

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A Review of Rhesus Iso-Immunization in a Nigerian Obstetric Population

Adeniran O. Fawole, Oladapo S. Sotiloye, Kehinde I. Hunyinbo, A. Durodola, S. I. Omisakin, A. O. Bale, A. Sadoh, U. A. Udo, Ayodele O. Oladimeji, E. Oladipo Otolorin


Context: Haemolytic disease of the newborn, a problem that has not been sufficiently investigated in the Nigerian population, leads to significant perinatal morbidity and mortality.
Objectives: To determine the incidence of Rhesus (Rh) isoimmunization and the utilisation rate of Rh-immunoprophylaxis in our population.
Methods: A review of the clinical records of all Rh-negative pregnancies, booked at the Federal Medical Centre, Abeokuta between July, 1996 and June, 2000. The mothers' and infants' records were analysed for age, parity, ante-natal antibody status and some selected characteristics in the infant.
Results: Seventy-seven Rh-negative pregnancies were managed, accounting for 2.6% of the total obstetric population. Those who received immuno-prophylaxis following previous abortions and deliveries were 15.4 % and 38.2% respectively. Initial testing, at booking, for sensitization was not done in 36.5% of the women, while 63.4% had no follow-up testing. The incidence of ante-natal sensitization was 1.3%. The time of onset of neonatal jaundice was 26.5 + 14.6 hours (mean + SD) in Rh-positive infants, compared to 44.4 + 17.8 hours in Rh-negative infants (p = 0.07). The haematocrit of both groups of infants were similar [42.8 + 5.8 versus 44.5 + 5.3; p = 0.6]. There was no perinatal death. The partners' Rh-status was determined in 59.7% and the infants' Rhesus group in 71.6%. Immunoprophylaxis rate was poor (44.8%). The majority of those who declined immunoprophylaxis did so for financial reasons.
Conclusion: The risk of haemolytic disease of the newborn with its attendant perinatal morbidity and mortality is real in our community, yet the rate of Rh-immunoprophylaxis remains quite low in our obstetric population.

(Tropical Journal of Obstetrics and Gynaecology: 2001, 18(2):69-72)
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