Abstract
Red blood cell (RBC) alloimmunization, or isoimmunization, is the development of maternal antibodies to fetal RBC antigens. A midwife, Louyse Bourgeois, first described hemolytic disease of the newborn in 1609 after delivering a set of twins. In the 1950s and 1960s, people began to see invasive testing take place to evaluate the fetus at risk for erythroblastosis fetalis. Maternal alloimmunization occurs when the gravid patient develops an immune response to a paternally derived antigen found on the surface of the fetal RBC. The most common antigen to cause RBC alloimmunization is Rh (D). The American Association of Blood Banks recommends reevaluation of Rh antibody status prior to the administration of Rh (D) immunoglobulin, postpartum, and after any traumatic events during the antepartum period. During the 1960s, efforts were made to prevent the formation of maternal antibodies. The American Association of Blood Banks recommends dosing at 28 weeks of gestation, postpartum, and after any suspected episodes of fetomaternal hemorrhage.