Anti-D immunoglobulin

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

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