Rh hemolytic disease of the fetus and newborn is a potential risk for D-negative mothers who produce anti-D during pregnancy, which can lead to morbidity and mortality in subsequent pregnancies. To prevent this hemolytic disease, Rho(D) immune globulin (RhIG) is generally administered to D-negative mothers without anti-D at 28 weeks of gestation and shortly after delivery. However, current guidelines suggest that pregnant mothers with molecularly defined weak D types 1, 2, 3, 4.0, and 4.1 do not need RhIG as they are unlikely to produce alloanti-D when exposed to fetuses with D-positive red cells. This issue and the necessity of RHD genotyping have been extensively discussed in Western countries, where these variants are relatively common. Recent evidence indicates that women with Asian-type DEL (c.1227G>A) also do not form alloanti-D when exposed to D-positive red cells. We report that mothers with molecularly defined Asian-type DEL, similar to those with weak D types 1, 2, 3, 4.0, and 4.1, do not require RhIG before and after delivery. Collectively, this review could pave the way for the revision of international guidelines to include the selective use of RhIG based on specific genotypes, particularly in women with the Asian-type DEL.

中文翻译：

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分子定义的亚洲型 DEL 女性 Rho(D) 免疫球蛋白指南 (c.1227G>A)。

胎儿和新生儿的 Rh 溶血病是 D 阴性母亲在怀孕期间产生抗 D 的潜在风险，这可能导致随后怀孕的发病和死亡。为了预防这种溶血性疾病，通常在妊娠 28 周和分娩后不久向没有抗 D 抗体的 D 阴性母亲注射 Rho(D) 免疫球蛋白 (RhIG)。然而，目前的指南建议，具有分子定义的弱 D 型 1、2、3、4.0 和 4.1 的孕妇不需要 RhIG，因为当暴露于 D 阳性红细胞的胎儿时，她们不太可能产生同种抗 D。这个问题和RHD基因分型的必要性在这些变异相对常见的西方国家已得到广泛讨论。最近的证据表明，患有亚洲型 DEL (c.1227G>A) 的女性在接触 D 阳性红细胞时也不会形成同种抗 D。我们报告说，患有分子定义的亚洲型 DEL 的母亲，与弱 D 型 1、2、3、4.0 和 4.1 的母亲类似，在分娩前后不需要 RhIG。总的来说，这次审查可以为修订国际指南铺平道路，包括根据特定基因型选择性使用 RhIG，特别是在患有亚洲型 DEL 的女性中。