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{
    "pk": 47264,
    "title": "The Complexity of Weak Rhesus Positivity in Pregnancy: Challenges and Management—A Case Report",
    "subtitle": null,
    "abstract": "<p><strong>Introduction: </strong>Determining a mother’s Rhesus (Rh) antigen status is a critical component of prenatal care, guiding the administration of Rh immunoglobulin (Rh Ig) to prevent Rh alloimmunization, a condition that can lead to hemolytic disease of the newborn (HDN). HDN is a blood disorder where the blood types of a mother and fetus are incompatible and causes hemolysis of the fetus’ erythrocytes, a major cause of fetal death. Rh Ig is commonly administered to Rh-negative (Rh-) women as a prophylactic measure. However, categorizing a patient’s Rh status is not always straightforward as individuals can exhibit “weakly Rh+” or “formerly Rh+” phenotypes, complicating clinical management.</p>\n<p><strong>Case Report: </strong>This is a case of a 28-year-old Gravida three Para two (G3P2) woman whose Rh status has varied across multiple pregnancies, who presented to the emergency department with an active miscarriage requesting a dose of Rh Ig.  Her blood typing indicated O+ status, which conflicted with her previous history of being O-.</p>\n<p><strong>Conclusion: </strong>Most women in the United States are Rh-positive (Rh+), which eliminates the need for Rh Ig during pregnancy. Nevertheless, there are approximately 550,000 women annually who are categorized as Rh-, and 16,700 of these cases may represent weak Rh positivity. Identifying weakly Rh+ individuals holds potential to reallocate scarce Rh Ig resources to those who require them. This report explores the clinical implications of weak Rh positivity, emphasizing maternal-fetal health considerations and the nuanced approach required to manage such cases effectively in the emergency department.  </p>",
    "language": "eng",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Anti-D-immunoglobulin"
        },
        {
            "word": "Rh-alloimmunization"
        },
        {
            "word": "Rhesus Ag"
        },
        {
            "word": "Rh immune globulin"
        },
        {
            "word": "rhogam"
        },
        {
            "word": "case report"
        }
    ],
    "section": "Case Reports",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/3790h51q",
    "frozenauthors": [
        {
            "first_name": "Meghan",
            "middle_name": "Grace",
            "last_name": "Warner",
            "name_suffix": "",
            "institution": "Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, South Carolina",
            "department": ""
        },
        {
            "first_name": "Nicole",
            "middle_name": "",
            "last_name": "Villa",
            "name_suffix": "",
            "institution": "Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, South Carolina",
            "department": ""
        },
        {
            "first_name": "Jordan",
            "middle_name": "",
            "last_name": "Winebrenner",
            "name_suffix": "",
            "institution": "Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, South Carolina",
            "department": ""
        },
        {
            "first_name": "Steven",
            "middle_name": "",
            "last_name": "Lewis",
            "name_suffix": "",
            "institution": "Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, South Carolina; Spartanburg Regional Hospital System, Department of Obstetrics and Gynecology, Spartanburg, South Carolina",
            "department": ""
        },
        {
            "first_name": "Lindsay",
            "middle_name": "",
            "last_name": "Tjiattas-Saleski",
            "name_suffix": "",
            "institution": "Edward Via College of Osteopathic Medicine - Carolinas Campus, Spartanburg, South Carolina; Prisma Health, Department of Emergency Medicine, Greenville, South Carolina",
            "department": ""
        }
    ],
    "date_submitted": "2025-04-17T16:50:38.679000-04:00",
    "date_accepted": "2025-07-09T14:42:43.850000-04:00",
    "date_published": "2025-09-24T00:00:00-04:00",
    "render_galley": null,
    "galleys": [
        {
            "label": "PDF",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/uciem_cpcem/article/47264/galley/40150/download/"
        }
    ]
}