Anti-D immunoglobulin
embeds
April 3, 2021
Rhesus (Rh)-D negative women, pregnant with Rh-D positive foetus are at risk of developing antibodies against future pregnancies if/when they suffer a sensitising event. (Remember, this should be considered a standard treatment for all Rh-D negative women, as we are never certain of the fathers Rh-D status)
Sensitising events:
- PV bleeding in pregnancy
- Miscarriage
- Ectopic/Molar pregnancy
- Abdominal trauma
- Termination of pregnancy (either medical or surgical)
- Intra-Uterine procedures/Biopsies
- Delivery
Recommendations following potentially sensitising events:
- Anti-D Ig should be administered as soon as possible and always within 72 h of the event.
- Some protection may be offered if anti-D Ig is given up to 10 days
- Deep IM injection (this can be difficult in the obese consider site and needle length)
- ≤20 weeks gestation 250 IU
- <12 weeks not recommended for threatened miscarriage
- >20 weeks gestation 500 IU
References
- NICE – ANTI-D (RH0) IMMUNOGLOBULIN
- RCOG – British Committee for Standards in Haematology (BCSH) guideline on anti-D administration in pregnancy
- RANZCOG – Guidelines for the use of Rh(D) Immunoglobulin (Anti-D) in obstetrics in Australia
- BestBets – The use of rhesus anti d prophylaxis in a pregnant trauma patient