Молодежный инновационный вестникМолодежный инновационный вестник2415-7805Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации10557Conference ProceedingsPeculiarities of pregnancy management in Rh-isoimmunisation, assessment of perinatal outcomes after spontaneous delivery and caesarean sectionHaprovaKristina Olegovna<p>Clinical Resident</p>KristinaHaprova@yandex.ruhttps://orcid.org/0000-0003-1267-3598DalnikovskayaLuiza Arturovna<p>PhD, researcher, Moscow Regional Research Institute of Obstetrics and Gynecology, Obstetric physiological departmens</p>liza.dalnikovskaya@yandex.ruhttps://orcid.org/0000-0001-5035-6564KapustinaMarina Vyacheslavovna<p>PhD, Head of the Obstetric Physiological Department of</p> <p>the GBUZ MO MONIAG</p>mvkapustina@yandex.ruhttps://orcid.org/0000-0001-6244-2136Moscow Regional Research Institute of Obstetrics and Gynecology, Obstetric Physiology Department3006202514141432802202508032025Copyright © 2025, Haprova K.O., Dalnikovskaya L.A., Kapustina M.V.2025<p>The problem of diagnosis and treatment of fetal and neonatal haemolytic disease (FHD) caused by Rhesus-isoimmunisation has not lost its relevance to date, despite a well-organised system of immunoprophylaxis, and remains one of the causes of perinatal mortality and disability. Perinatal mortality due to foetal haemolytic disease (FHD) in our country reaches 15-16 .According to the current clinical recommendations of the Ministry of Health of the Russian Federation Rhesus-isoimmunisation. Haemolytic disease of the fetus 2024, after intrauterine transfusion of washed red blood cells to the fetus, abdominal delivery is preferable, which avoids additional traumatisation and distress of the fetus during labour. However, modern studies suggest that the choice of the method of delivery should be based on obstetric indications. Objective. To demonstrate the possibility of choosing the method of delivery based on obstetric indications in pregnant women with GBP after multiple VPKs. Materials and Methods. Two clinical examples of the course of pregnancy complicated by Rh-isoimmunisation are presented. Labour histories, anamnesis data, clinical, laboratory and instrumental investigations were analysed. Results. Two observations of Rh-isoimmunisation complicated by GBP were described in the presented clinical cases, which necessitated fourfold MIC in both pregnant women. The method of delivery did not affect the outcome of labour, both children were born in satisfactory condition. Conclusion. Current management of pregnant women with Rh-isoimmunisation tends to intrauterine EMOLT transfusions at a later date in order to reduce perinatal complications associated with prematurity. In addition, compensation of intrauterine anaemia on the eve of delivery makes it possible to choose the method of delivery based on the obstetric situation.</p>hemolytic disease of the fetus and newbornrhesus conflictcordocentesisIUTexchange blood transfusionгемолитическая болезнь плода и новорожденногорезус-конфликт  кордоцентезВПКоперация заменного переливания крови1.Гемолитическая болезнь плода и новорождённого: диагностика, лечение, профилактика: учебное пособие / Н.Н. Володин [и др.]. — Москва: РНИМУ им. Н.И. Пирогова, 2020. — 92 с.2.Donepudi, R. V. et al. Perinatal survival following intrauterine transfusion for red cell alloimmunized pregnancies: systematic review and meta-regression. Am J Obstet Gynecol 230, e1-e2, doi:10.1016/j.ajog.2023.10.016 (2024).3.Российское общество акушеров-гинекологов. Клинические рекомендации «Резус-изоиммунизация. Гемолитическая болезнь плода» – 2024 (05.09.2024) – Утверждены Минздравом РФ.4.А.А. Смирнова , А.Г. Коноплянников , Е.Я. Караганова Многократные внутриутробные переливания крови при резуссенсибилизации и тяжелых формах гемолитической болезни плода [Текст] / А.А. СМИРНОВА , А.Г. КОНОПЛЯННИКОВ , Е.Я. КАРАГАНОВА // Российский вестник акушера-гинеколога. — 2021. — № 1. — С. 61-68.5.С.В. Хабаров, О.В. Денисова, В.М. Девиченский Роль молекулярно-генетической неинвазивной лабораторной диагностики в профилактике резус-конфликтной беременности [Текст] / С.В. Хабаров, О.В. Денисова, В.М. Девиченский, // Медицинский алфавит . — 2019. — № 3 - 22. — С. 78-83.