Despite regulatory approval in 1968 for the human use of Rh(D) immune globulin to prevent Rh disease of the fetus and newborn, Rh disease still occurs in many parts of the world. In fact, Rh(D) immune globulin is ~99% effective at preventing Rh disease when women receive the drug both antepartum and postpartum. As a result, Rh disease has virtually disappeared from Western Europe, Canada, the United States, and Australia. However, due to a lack of education, awareness, and availability of the drug, Rh disease remains prevalent in other parts of the world, leading to hundreds of thousands of families affected by repeated miscarriages, stillbirths, and neonates with hyperbilirubinemia-related adverse outcomes, including kernicterus spectrum disorder. Indeed, it is estimated that ~50% of the pregnant women around the world who need Rh(D) immune globulin do not receive it, which amounts to ~2.5 million women each year.
This educational session will provide up-to-date information regarding the continuing global burden of disease for this disorder, explore the reasons why this problem persists, and offer potential solutions for remediation. It will also provide attendees with the most current consensus approaches for preventing Rh disease in various clinical settings. Finally, several new therapeutic approaches have been recently proposed to prevent and/or treat Rh disease, in particular, and other variants of hemolytic disease of the fetus and newborn, in general; these will be described along with a discussion of their underlying therapeutic mechanisms.
Appreciate the ongoing global burden of Rh disease, explain various reasons for this phenomenon in different high income and low-middle income countries around the world, and propose several possible remediation strategies.
Describe current consensus approaches for preventing Rh disease in various clinical settings, particularly focusing on approaches in high income and low-middle income countries.
Describe two novel approaches for preventing and/or treating hemolytic disease of the fetus and newborn (i.e., monoclonal Rh(D) immunoglobulin and monoclonal antibody to the neonatal Fc receptor (FcRn)), and describe the relevant therapeutic mechanism(s).
Assistant Professor, Department of Pathology and Cell Biology,
Columbia University Medical Center