BMJ 1994;309:213-214 (23 July)

Editorials

Preventing Rh immunisation

Without prophylaxis, about one in six Rh negative women who deliver a Rh positive infant will develop anti-D antibodies from fetomaternal haemorrhage occurring either during pregnancy or at delivery.1 Since the introduction in 1969 of anti-D immunoglobulin given after delivery the incidence of haemolytic disease of the newborn due to anti-D antibodies has plummeted. In Britain, however, the rate of RhD sensitisation is still unacceptably high, at around 1.5%; in other words, more than 1000 Rh negative women each year develop anti-D antibodies in association with the delivery of a Rh positive infant.

No universal policy exists for postnatal prophylaxis. The standard dose of anti-D immunoglobulin and whether tests are undertaken to assess the size of the fetomaternal haemorrhage vary in different countries. For example, 300 µg anti-D immunoglobulin is the standard dose in the United States, 100-120 µg in Canada, and 200-250 µg in many European countries except Britain . . . [Full text of this article]


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This article has been cited by other articles:

  • JAMES, D. (1998). Anti-D prophylaxis in 1997: The Edinburgh Consensus Statement. Arch. Dis. Child. Fetal Neonatal Ed. 78: 161F-163 [Full text]  
  • Mayne, S., Parker, J. H, Harden, T. A, Dodds, S. D, Beale, J. A (1997). Rate of RhD sensitisation before and after implementation of a community based antenatal prophylaxis programme. BMJ 315: 1588-1588 [Full text]  
  • Balfour, R P, Williams, F G, Napier, J A F (1994). Value of Kleihauer test. BMJ 309: 1020d-1021 [Full text]  
  • Love, E M, Shwe, K H, Urbaniak, S J, Main, R, Fraser, N, Duguid, J K M, Bromilow, I M, Van Dijk, B A, De Man, C J M, Kunst, V A J M, Murphy, W G, Ghosh, S, Hughes, R H, Craig, J I O, Greer, I A (1994). Kleihauer testing Need not be abandoned. BMJ 309: 805-805 [Full text]  
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