The Allo Podcast

Molly and Bethany address the common question many families wonder about what to do to monitor their HDFN baby once they’re home, and how to know when baby is finally cleared of HDFN. They share their children’s post-discharge monitoring plans, which cover a full spectrum of HDFN severity.If you haven’t already, listen to Season 1 Episode 13 about the neonatal HDFN period. Common terms discussed in this episode: Newborn hemolytic anemiaNewborn hyperbilirubinemia Hemoglobin/hematocritReticulocytesErythropoietin/darbepoetin/ESAsThrombocytopeniaNeutropeniaPediatric hematologistExample transfusion thresholds provided in our Excellent Neonatal Care Practices resource here.References in this episode: Clinical study showing the effectiveness of ESAs for neonatal HDFN: Ree IM, de Haas M, van Geloven N, Juul SE, de Winter D, Verweij EJ, Oepkes D, van der Bom JG, Lopriore E. Darbepoetin alfa to reduce transfusion episodes in infants with haemolytic disease of the fetus and newborn who are treated with intrauterine transfusions in the Netherlands: an open-label, single-centre, phase 2, randomised, controlled trial. The Lancet Haematology. 2023 Dec 1;10(12):e976-84.Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.

Bethany and Molly address iron and its dangers to the HDFN newborn in this quick, science-based episode. Together they address the dangers of iron overload and the confusion around why iron is often mistakenly included in the treatment regimen for newborns experiencing alloimmunized anemia, as well as treatments for extreme conditions. Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.References in this episode: Study on iron overload at birth in HDFN newborns: Rath ME, Smits-Wintjens VE, Oepkes D, Walther FJ, Lopriore E. Iron status in infants with alloimmune haemolytic disease in the first three months of life. Vox Sang. 2013 Nov;105(4):328-33. doi: 10.1111/vox.12061. Epub 2013 Jun 27. Available here.Case report of iron overload resolving: Adam DL, Bowes L, Goodyear L, Moorehead PC. Conservative Management of Hyperferritinemia in Hemolytic Disease of the Fetus and Newborn: A Case Report and Review of the Literature. J Pediatr Hematol Oncol. 2021 Mar 1;43(2):73-76. Available here.

Katie rejoins Bethany and Molly to discuss the NICU experience including why HDFN babies sometimes need NICU time, how long and how often NICU is necessary, what to expect to hear and see in the NICU, and important resources to prepare and navigate an HDFN NICU experience.Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.References in this episode:Neonatal excellent care checklist: available here. HDFN Health Record: available here. Merch store to get a “I wear my sunglasses at night” onesie: access here.

In this quick, science-focused episode, Molly and Bethany break down how IVIG (intravenous immunoglobulin) is used during alloimmunized pregnancies to help delay fetal anemia and reduce the risks of severe HDFN. They explain who may benefit, how the treatment works, what the latest guidelines say, and why IVIG can be a life-saving tool when started early and used thoughtfully.Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyReferences in this episode: New meta-analysis on use of IVIG: Mustafa HJ, Sambatur EV, Pagani G, D’Antonio F, Maisonneuve E, Maurice P, Zwiers C, Verweij JE, Flood A, Shamshirsaz AA, Jouannic JM. Intravenous immunoglobulin for the treatment of severe maternal alloimmunization: individual patient data meta-analysis. American journal of obstetrics and gynecology. 2024 Oct 1;231(4):417-29. Available here.Benefits of delaying first IUT to beyond 20 weeks: Lindenburg IT, van Kamp IL, van Zwet EW, Middeldorp JM, Klumper FJ, Oepkes D. Increased perinatal loss after intrauterine transfusion for alloimmune anaemia before 20 weeks of gestation. BJOG. 2013 Jun;120(7):847-52. Available here.Pregnancy management guidelines: Moise KJ, Markham KB, Spinella PC, Sherwood MR, Robinson KA, Wilson LM, Malone J, Espinoza J, Dizon-Townson D, Mercer L, Miller R. A Clinical Practice Guideline for the Management of Pregnancy Alloimmunized to Red Blood Cell Antigens. JAMA Network Open. 2025 Nov 3;8(11):e2544649-. Available here. Note that additional practice points are in the supplemental content. To access all recommendations, practice points, and their rationale, we recommend clicking “supplemental content”, downloading the file, and accessing Table 4. This provides all information in one table for easy printing and reference.Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.

Join Bethany and Molly in an interview with Kate and Dewayne as they recount their experience with a tragic preventable loss due to HDFN followed by the redemption of a beautiful living son. Part two takes our listeners through Kate’s most recent pregnancy, managed by Dr. Trevett, with a joyful ending.Show themes: Anti-D, Anti-C alloimmunized pregnancyHigh titerIVIG/plasmapheresisIntrauterine transfusions Healthy outcome with the right careWatch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.

Join Bethany and Molly in an interview with Kate and Dewayne as they recount their experience with a tragic preventable loss due to HDFN followed by the redemption of a beautiful living son. In part one, the group discusses Kate and Dewayne’s experience with a loss that resulted in her sensitization, and Kate’s next pregnancy that ended with the tragic discovery of Kate’s condition at the end of the pregnancy. Stay tuned for the redemption story in Part 2.Show themes: Anti-D, Anti-C alloimmunized pregnancyHigh titerFull-term loss due to HDFNPrevious pregnancy loss and medical trauma Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.Please consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.

Bethany and Molly share all about plasmapheresis, including photos and videos and practical tips to give their listeners a clear picture of what it is and when it’s used in cases of severe HDFN. Watch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.References in this episode: Benefits of delaying first IUT to beyond 20 weeks: Lindenburg IT, van Kamp IL, van Zwet EW, Middeldorp JM, Klumper FJ, Oepkes D. Increased perinatal loss after intrauterine transfusion for alloimmune anaemia before 20 weeks of gestation. BJOG. 2013 Jun;120(7):847-52. Available here.Use of plasmapheresis: Lei Y, Liang Y, Hao X, Zhu W, Zhang X, Zheng Z, Wang X. Double-filtration plasmapheresis as an adjunct to therapy for severe early-onset maternal erythrocyte alloimmunization. BMC Pregnancy and Childbirth. 2025 Nov 7;25(1):1169. Available here.

403 The New HDFN Guidelines: A Historic Moment for FamiliesIn this historic episode of the Allo Podcast from the Allo Hope Foundation, hosts Bethany Weathersby and Molly Sherwood celebrate the release of new evidence-based, expert-backed, and patient-informed guidelines for the prevention and management of Hemolytic Disease of the Fetus and Newborn (HDFN). They discuss why these comprehensive guidelines were urgently needed to address longstanding care gaps, highlight key prenatal and neonatal recommendations that could save lives, and share the unique collaborative process behind their creation. Listeners are encouraged to access and implement these guidelines to improve outcomes for alloimmunized families.Watch this episode on YouTubeAccess all guidelines resources on our guidelines landing page (we upload the published manuscripts and associated resources as they become available): https://allohopefoundation.org/clinical-practice-guidelines/Pregnancy management guidelines: Moise KJ, Markham KB, Spinella PC, Sherwood MR, Robinson KA, Wilson LM, Malone J, Espinoza J, Dizon-Townson D, Mercer L, Miller R. A Clinical Practice Guideline for the Management of Pregnancy Alloimmunized to Red Blood Cell Antigens. JAMA Network Open. 2025 Nov 3;8(11):e2544649-. Available here. Note that additional practice points are in the supplemental content. To access all recommendations, practice points, and their rationale, we recommend clicking “supplemental content”, downloading the file, and accessing Table 4. This provides all information in one table for easy printing and reference.If you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.Our most sincere thank you to all clinicians and patients involved in the guidelines development process, including: Philip Spinella, MD; Christine Leeper, MD; Molly Sherwood; Bethany Weathersby, MEd; Mark Yazer, MD; Cassandra Josephson, MD; Jennifer Andrews, MD; Kenneth Moise Jr, MD; Timothy Bahr, MD; Allison Ayapantecatl; Nick Carr, DO, FAAP; Ravi Patel, MD; Robert Christensen, MD; Sarah Ilstrup, MD; Jon Watchko, MD; Karen Robinson, PhD, MSc; Lisa Wilson, ScM; Anthony Sciscione, DO; Donna Dizon-Townson, MD; Jimmy Espinoza, MD, Msc; Juan González Vélez MD, PhD; Kara Markham, MD; Laura Mercer, MD, MBA, MPH; Leonardo Pereira, MD, M.C.R.; Russell Miller, MD; Saul Snowise, MD; Alireza Shamshiraz, MD; Thomas Trevett, MD; Andre Cap, MD, PhD; Jeanne Hendrickson, MD; Paul Ness, MD; Ross Fasano, MD; Stella Chou, MD; Alyssa Ziman, MD; Barbara Gaines, MD; Bryan Cotton, MD, MPH; Denis Snegovskikh, MD; Donald Jenkins, MD; Frank Guyette, MD; Jason Sperry, MD; Jay Malone, MD, MS, PhD; COL Jennifer Gurney, MD; Joseph Sakran, MD, MPA, MPH; Juan Duchesne, MD; Katie Shanahan, CPNP; Nancy Dunbar, MD; Pampee Young, MD; Rich Gammon, MD; Susan Stern, MD; CAPT Travis Polk, MD

Bethany and Molly make a mini episode all about cell free fetal DNA, the blood test on mom that can determine a baby’s antigen status beginning around 10 weeks gestation. This is an accurate, non-invasive way to find out if a baby is at risk of HDFN by capturing free-floating fetal DNA from the mother’s blood and testing it to see if baby has the antigen that the mom’s antibodies may attack, causing HDFN. We also suggest listening to Season 1 Episode 2 about Prenatal Blood Tests.Watch this episode on YouTubeCffDNA is officially recommended in the recently published clinical practice guidelines (listen to previous episode, S4E3, for more information about the guidelines): Moise KJ, Markham KB, Spinella PC, Sherwood MR, Robinson KA, Wilson LM, Malone J, Espinoza J, Dizon-Townson D, Mercer L, Miller R. A Clinical Practice Guideline for the Management of Pregnancy Alloimmunized to Red Blood Cell Antigens. JAMA Network Open. 2025 Nov 3;8(11):e2544649-. Available here. Note that additional practice points are in the supplemental content. To access all recommendations, practice points, and their rationale, we recommend clicking “supplemental content”, downloading the file, and accessing Table 4. This provides all information in one table for easy printing and reference.Options for cffDNA in various countries: cffDNA from Sanquin Laboratories (Netherlands; can be shipped internationally) (D, E, C, c, K) Information here.cffDNA from BillionToOne’s Unity Screen (U.S.) (D, E, C, c, K, Fya) Publication here. Order form here.cffDNA from Natera’s Panorama test (U.S.) (D) Information here.cffDNA from NHS (UK/Ireland) (D, E, C, c, K) Information here.cffDNA from Canadian Blood Services (D, E, C, c, K; 16-20 weeks gestation) Information here.cffDNA from Lifeblood (Australia) (D, E, K, k, E, c, Fya, Fyb; 12 weeks gestation) Information here.More resources about cffDNA: Moise Jr KJ. The use of free DNA for fetal RHD genotyping in the Rh negative pregnant patient—the time has come. American Journal of Obstetrics and Gynecology. 2025 Feb 1;232(2):188-93. Available here.Gandhi M. Paternal and Fetal Genotyping in the Management of Alloimmunization in Pregnancy. Available here.Regan F, Veale K, Robinson F, Brennand J, Massey E, Qureshi H, Finning K, Watts T, Lees C, Southgate E, Robinson S. Guideline for the investigation and management of red cell antibodies in pregnancy: A British Society for Haematology guideline. Transfusion Medicine. Available here.View all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.

When Kayla discovered anti-Kell antibodies at just 12 weeks, a sky-high titer and a terrifying 1.64 MCA score at 15 weeks sent her and her husband on a same-day flight from Pennsylvania to Austin, Texas for an emergency intraperitoneal transfusion—the first of nine lifesaving IUTs that would turn them into frequent flyers and the Dell Children’s fetal team into family. Kayla’s story is a powerful reminder that when the stakes are your child’s life, you do whatever it takes—and that knowledge, advocacy, and the right medical team really do save babies.Show themes: Anti-K alloimmunized pregnancyHigh-titer alloimmunized pregnancyLong-distance travel for specialty care Intrauterine transfusionPhenobarbital (for the mother prior to delivery)Darbepoetin (in the newborn with HDFN)Severe HDFN survivalWatch this episode on YouTubeView all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click Here to make a one-time or recurring donation.References in this episode: Neonatal best practices document that Kayla used in the NICU: Read here.Phenobarbital before delivery to help mature fetal liver: Trevett Jr TN, Dorman K, Lamvu G, Moise Jr KJ. Antenatal maternal administration of phenobarbital for the prevention of exchange transfusion in neonates with hemolytic disease of the fetus and newborn. American journal of obstetrics and gynecology. 2005 Feb 1;192(2):478-82. Read here.Use of erythropoietin or darbepoetin to reduce the number of top-up transfusions in babies with HDFN and a history of IUT: Ree IM, de Haas M, van Geloven N, Juul SE, de Winter D, Verweij EJ, Oepkes D, van der Bom JG, Lopriore E. Darbepoetin alfa to reduce transfusion episodes in infants with haemolytic disease of the fetus and newborn who are treated with intrauterine transfusions in the Netherlands: an open-label, single-centre, phase 2, randomised, controlled trial. The Lancet Haematology. 2023 Dec 1;10(12):e976-84. Read Here

Bethany and Molly kick off Season 4 with a dive into the weirdest corners of HDFN — from mind-blowing bizarre facts (like babies born with 100% donor blood and drones parachuting blood bags in Africa) to rare case studies featuring anti-Kell + anti-D, the ultra-rare anti-KU and anti-PP1P˩K antibodies, and a mystery about false-positive newborn screens that still has experts stumped.Watch this episode on YouTube Do you have any ideas about why some infants who have received IUTs test (falsely) positive for certain metabolic syndromes in their newborn screens? E-mail us at [email protected] all of our resources at www.allohopefoundation.orgIf you are an alloimmunized mother from any country, you are welcome in our Facebook support group called “Antibodies in Pregnancy: An AHF Support Group. Join here. https://www.facebook.com/groups/antibodiesinpregnancyPlease consider donating to AHF. If you are a listener, you know we do a lot with a little. Not sure how much will make a difference? An antibody screen in Kenya costs $13 USD. A dose of RhIG for a mother who cannot afford it is $80 USD. Click here to make a one-time or recurring donation.References in this episode: Read more about the “grandmother effect” here where a female fetus can become exposed to her mother’s Rh(D) positive blood in utero, priming her for Anti-D sensitization: here.Gender as a risk factor for developing neutropenia in HDFN: Alkhani A, Arefi A, AlTayeb M, Naaz S, Alghanbar J, Alhuthil R, Alrowaily F, Almidani E. Incidence and risk factors of neutropenia in neonates with hemolytic disease of the newborn. International Journal of Pediatrics and Adolescent Medicine. 2024 Sep 1;11(3):83-7. Available here.; Blanco E, Johnston DL. Neutropenia in infants with hemolytic disease of the newborn. Pediatric blood & cancer. 2012 Jun;58(6):950-2. Available here.Read about drone delivery of blood in Rwanda: here.Anti-PP1PK literature review and case presentations: Di Ciaccio P, Cutts B, Alahakoon TI, Dennington PM, Soo LA, Curnow J. Clinical consequences of the extremely rare anti‐PP1Pk isoantibodies in pregnancy: a case series and review of the literature. Vox Sanguinis. 2021 May;116(5):591-600. Available here.

New Episodes of the Allo Podcast coming to a podcast platform near you 1-27-25.

Bethany and Molly close out Amanda’s incredible survival story that began in Episode 2 of this season (Low Titer Pregnancies). After a rapid increase in titers from too low to titer to 2,048, Amanda’s referral to an MFM team went unnoticed for a few weeks. By the time she was seen, her son was very sick, but he was in the right hands with Dr. Snowise and his team. Listen to this miraculous story unfold. Then, Bethany and Molly reflect on AHF’s accomplishments and goals for the year and close with a powerful reflection that will touch the hearts of every listener, ending with a special dedication. References in this episode: Nipocalimab trial results: NipocalimabUse of cffDNA to find fetal antigen status for D, E, C, c, K, Fya: Fetal Antigen StudyESAs for newborns with HDFN to reduce the number of transfusions: Transfusion ReductionDonate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany, Katie and Molly talk together about how their parenting is affected during and after the life-changing experience of an alloimmunized pregnancy.Donate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany and Molly interview Dr. Timothy Bahr, a neonatologist with a specialty in neonatal hematology about all of your HDFN questions for newborns. Dr. Bahr patiently answers many of the common challenges and questions in neonatal HDFN care. This is an advanced discussion of neonatal HDFN. For a primer describing disease presentation, visit our neonatal episode in Season 1.Questions answered in this episode:What does it entail to prepare blood for a neonatal exchange transfusion?When and how do you use erythropoietin/darbepoetin (ESAs)?When does an HDFN baby need to be referred to hematology after discharge?Heel prick versus blood draw from a vein, does it matter?Is it ok to do transcutaneous bilirubin readings (with a small device on the skin instead of blood draw)?When is a baby cleared from HDFN?Why can’t we have the same neonatologist throughout a baby’s NICU stay?How can a mother politely insist on regular laboratory testing for their newborn with HDFN?How can a mother explain to the team at birth that it’s very important to get an immediate bilirubin check at birth (through cord or placenta if possible)?What’s the difference between neonatal and pediatric hematologist?Publications mentioned in this episode: Delayed cord clamping in alloimmunization: https://www.sciencedirect.com/science/article/abs/pii/S2589933323003075Iron overload in HDFN: https://scholarlypublications.universiteitleiden.nl/access/item%3A2881417/download#page=194Systematic review on IVIG in the neonate for HDFN: https://fn.bmj.com/content/99/4/F325.shortLeiberman et al on IVIG in the neonate for HDFN: https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.18170Darbepoetin to reduce the need for neonatal transfusion: https://cdn.clinicaltrials.gov/large-docs/26/NCT03104426/Prot_000.pdfPublications by Dr. Tim Bahr: https://pubmed.ncbi.nlm.nih.gov/?term=Bahr_TMPublications by Tim’s mentor, Dr. Robert (Bob) Christensen: https://pubmed.ncbi.nlm.nih.gov/?term=Christensen_RDDonate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany and Molly interview Dr. Timothy Bahr, a neonatologist with a specialty in neonatal hematology about all of your HDFN questions for newborns. Dr. Bahr patiently answers many of the common challenges and questions in neonatal HDFN care. This is an advanced discussion of neonatal HDFN. For a primer describing disease presentation, visit our neonatal episode in Season 1.Questions answered in this episode:What is this research you’re doing on measuring hemolysis in a fetus from the mother’s breath?Can you still have delayed cord clamping in alloimmunized pregnancies? Can I hold my baby for a few minutes before they are taken to the NICU?Why are HDFN babies offered iron so often?How quickly does a baby’s bilirubin level improve (go down) after an exchange transfusion?What is your opinion on using IVIG on the neonate for HDFN, and when would you do it?Publications mentioned in this episode: Delayed cord clamping in alloimmunization: https://www.sciencedirect.com/science/article/abs/pii/S2589933323003075Iron overload in HDFN: https://scholarlypublications.universiteitleiden.nl/access/item%3A2881417/download#page=194Systematic review on IVIG in the neonate for HDFN: https://fn.bmj.com/content/99/4/F325.shortLeiberman et al on IVIG in the neonate for HDFN: https://onlinelibrary.wiley.com/doi/pdf/10.1111/bjh.18170Darbepoetin to reduce the need for neonatal transfusion: https://cdn.clinicaltrials.gov/large-docs/26/NCT03104426/Prot_000.pdfPublications by Dr. Tim Bahr: https://pubmed.ncbi.nlm.nih.gov/?term=Bahr_TMPublications by Tim’s mentor, Dr. Robert (Bob) Christensen: https://pubmed.ncbi.nlm.nih.gov/?term=Christensen_RDDonate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany and Molly build on last season’s discussion of grief to expand to anxiety, stress, depression and PTSD during and after the experience of a high risk pregnancy. They talk through how these challenges present themselves, how they feel to an alloimmunized mother, and specific coping mechanisms. The close with a positive segment called “what’s in the bag”, where moms submitted lists of items that they packed for their delivery, IUT, and NICU visits.Mental health burden in alloimmunized pregnancy: https://www.ajog.org/article/S0002-9378(23)01145-6/pdfDonate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany, Molly and Katie talk through all aspects of Rh Immune Globulin (RhOGAM, WinRho, RhIG). They cover the history, how it’s made, its safety profile, understanding the RhIG shortage, and public health controversy. The women provide information for Rh negative women who are deciding whether or not to accept the RhIG injection for a pregnancy. Do you live in the U.S. and have Anti-D antibodies? You could be paid more than $100 per plasma donation (up to twice a week) with reimbursement for travel to a donation center. E-mail us at [email protected] and Bethany, Katie or Molly will respond to confirm your potential eligibility and refer you directly to our personal contact at Kedrion. Learn about Kedrion, the manufacturer of RhoGAM: https://www.kedrion.com/therapies/RhoGAM website: https://www.rhogam.com/Donate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support Facebook

Bethany, Molly and Katie talk through differences in HDFN care continent by continent. They review country-specific research, practice patterns, and patient stories. Donate to AHF: Allo Hope DonateAHF Merch: Allo Hope MerchWatch this episode on YouTube: Allo Hope on YouTubeJoin the AHF patient support group: AHF Support FacebookCross-matching for Kell in Netherlands: Luken JS, Folman CC, Lukens MV, Meekers JH, Ligthart PC, Schonewille H, Zwaginga JJ, Janssen MP, van Der Schoot CE, van der Bom JG, de Haas M. Reduction of anti‐K‐mediated hemolytic disease of newborns after the introduction of a matched transfusion policy: a nation‐wide policy change evaluation study in the Netherlands. Transfusion. 2021 Mar;61(3):713-21. Iceland study: Gudlaugsson B, Hjartardottir H, Svansdottir G, Gudmundsdottir G, Kjartansson S, Jonsson T, Gudmundsson S, Halldorsdottir AM. Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: A nation‐wide population study prior to routine antenatal anti‐D prophylaxis. Transfusion. 2020 Jan;60(1):175-83. South Korea study: Yang EJ, Shin KH, Song D, Lee SM, Kim IS, Kim HH, Lee HJ. Prevalence of unexpected antibodies in pregnant Korean women and neonatal outcomes. The Korean Journal of Blood Transfusion. 2019 Apr 30;30(1):23-32. Saudi Arabia study: Alkhaibary A, Ali M, Tulbah M, Al-Nemer M, Khan RM, Al Mugbel M, Al Sahan N, Hassounah MM, Alshammari W, Kurdi WI. Complications of intravascular intrauterine transfusion for Rh alloimmunization. Annals of Saudi Medicine. 2021 Nov;41(6):313-7.Iran study: Niroomanesh S, Dadgar S, Shirazi M, Sharbaf FR, Golshahi F. Neonatal outcomes of Rh alloimmunization pregnancy treated with intrauterine transfusion. Med. Sci.. 2020;24(101):57-65.Japan study: Mizuuchi M, Murotsuki J, Ishii K, Yamamoto R, Sasahara J, Wada S, Takahashi Y, Nakata M, Murakoshi T, Sago H. Nationwide survey of intrauterine blood transfusion for fetal anemia in Japan. Journal of Obstetrics and Gynaecology Research. 2021 Jun;47(6):2076-81.Canada study: Jackson ME, Baker JM. Hemolytic disease of the fetus and newborn: historical and current state. Clinics in Laboratory Medicine. 2021 Mar 1;41(1):133-51.Brazil study: Pares DB, Pacheco GH, Lobo GA, Araujo Júnior E. Intrauterine Transfusion for Rhesus Alloimmunization: A Historical Retrospective Cohort from A Single Reference Center in Brazil. Journal of Clinical Medicine. 2024 Feb 28;13(5):1362.