A Rare Case of Rh Isoimmunization Managed Successfully With Intrauterine Transfusion and Timely Delivery

Background: Rh isoimmunization is an important cause of hemolytic disease of the fetus and newborn, potentially resulting in severe fetalanemia, hydrops fetalis, and perinatal mortality. Advances in fetal surveillance and intrauterine transfusion have significantly improved pregnancy outcomes. Aims: To evaluate the clinical profile, management, and maternal-fetal outcomes of Rh isoimmunized pregnancies, with special emphasis on the role of intrauterine transfusion and timely delivery. Materials and Methods: This prospective observational study was conducted over 2 years in the Department of Obstetrics and Gynaecology at Sir Ramanand Tirth Rural Medical College, Ambajogai, Maharashtra. A total of 30 Rh isoimmunized pregnant women were enrolled. Maternal demographics, antibody titres, fetal Doppler findings, intrauterine transfusion details, mode of delivery, and neonatal outcomes were analyzed. Results: Most women were aged 25–29 years (40.0%) and were multigravida (36.7% G4). Elevated MCA-PSV was observed in 80.0% of fetuses. A single intrauterine transfusion was sufficient in 60.0% of cases, while 56.7% delivered between 36 and 37 weeks. Higher maternal antibody titres were significantly associated with neonatal jaundice and NICU admission (p = 0.003). Conclusion: Early diagnosis, serial fetal surveillance, intrauterine transfusion, and timely delivery effectively improved perinatal outcomes in Rh isoimmunized pregnancies. Multidisciplinary management remains essential for reducing fetal and neonatal complications.