The Allo Podcast

Rose and Katie return for an intimate discussion with Bethany and Molly about the realities of HDFN in Kenya. The group discuss the five pillars of prevention, diagnosis, monitoring, treatment and maternal support and what they each look like for Kenyan families. An important and humbling episode for listeners who may not have access to a deeper understanding of HDFN realities in underserved communities.

Watch this episode on YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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.

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 anemia
• Newborn hyperbilirubinemia 
• Hemoglobin/hematocrit
• Reticulocytes
• Erythropoietin/darbepoetin/ESAs
• Thrombocytopenia
• Neutropenia
• Pediatric hematologist

Example 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 YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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 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 YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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.

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 YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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.

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 YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

References 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 pregnancy
• High titer
• IVIG/plasmapheresis
• Intrauterine transfusions 
• Healthy outcome with the right care

Watch this episode on YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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. 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 pregnancy
• High titer
• Full-term loss due to HDFN
• Previous pregnancy loss and medical trauma 

Watch this episode on YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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.

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 YouTube

View all of our resources at www.allohopefoundation.org

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/antibodiesinpregnancy

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.

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 Families

In 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 YouTube

Access 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/antibodiesinpregnancy

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.

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 YouTube

CffDNA 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.org

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/antibodiesinpregnancy

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.