TY - JOUR T1 - The global burden of Rh disease JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F84 LP - F85 DO - 10.1136/adc.2009.181172 VL - 96 IS - 2 AU - Alvin Zipursky AU - Vinod K Paul Y1 - 2011/03/01 UR - http://fn.bmj.com/content/96/2/F84.abstract N2 - Rh negative women who deliver an Rh positive baby are at risk of developing anti-Rh antibodies.1 Rh positive babies born of these mothers will develop Rh haemolytic disease. This is a severe condition responsible for death in utero or in the neonatal period or severe jaundice with ensuing brain damage. The natural history of the disease has not been described in recent literature. Walker,1 in 1971, reviewed a series of cases from his community. It was found that 14% of affected pregnancies resulted in stillbirths. Of the survivors, 30% had severe disease almost certainly fatal without treatment, while an additional 30% had moderate disease which would manifest as severe hyperbilirubinaemia that untreated may result in brain damage and/or death. Forty per cent of cases would require no treatment. Therefore, it can be estimated that approximately 50% of children with untreated haemolytic disease of the newborn (HDN) will die of the disease or develop brain damage. Similar observations were made in Manitoba, Canada.2Over 30 years ago it was established that Rh isoimmunisation could be prevented by passive immunisation with anti-Rh (anti-D) γ globulin.3 4 Thereafter, prevention of Rh disease was instituted using postpartum injections of anti-Rh (anti-D) γ globulin; this has been proven to be highly effective.5In most developed, high income countries, all Rh negative postpartum women whose babies are Rh positive … ER -