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Altered strategy of prophylactic anti‐D administration in pregnancy to cover term and post‐term – a pilot study
- Source :
- Vox Sanguinis. 116:1005-1011
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Background and objective Routine antenatal anti-D prophylaxis (RAADP) to RhD-negative women is most often administered in gestational age (GA) 28-30 weeks with the next anti-D dose administered postpartum. The aim of this study was to analyse the proportion of RhD-negative women where RAADP is not detectable at term and in a pilot study to investigate whether RAADP administered in GA 28 and 38 results in detectable levels at term, post-term and post-delivery. Materials and methods In a retrospective analysis, 4280 RhD-negative women carrying an RHD positive fetus were included and the proportion with a negative antibody screen at delivery was determined. In the second part, 39 pregnancies were included prospectively, a second dose of RAADP was administered in GA 38 weeks, and anti-D was quantified before the second dose and then weekly for 5 weeks. Results In the retrospective analysis, 20·5% (856/4280) with RAADP administered in GA 28 were negative in routine antibody screening at delivery. In the small prospective study, 18% (7/39) had a negative antibody screen and 26% (10/39) had levels below 0·005 IU/ml, in the quantification assay, in GA 38. Anti-D prophylaxis administered in GA 38 showed detectable levels of anti-D up to 30 days post-delivery, with concentration at delivery 0·060 ± 0·034 IU/ml (mean ± SD). Conclusion Approximately 20% of the RhD-negative women show non-detectable levels of anti-D at term. A second dose of RAADP at GA 38 results in stable concentrations of anti-D at term, post-term and post-delivery, but with large interindividual variation.
- Subjects :
- medicine.medical_specialty
Rho(D) Immune Globulin
Negative antibody
RhD positive
Pilot Projects
030204 cardiovascular system & hematology
Rh Isoimmunization
03 medical and health sciences
0302 clinical medicine
Pregnancy
medicine
Retrospective analysis
Humans
Prospective Studies
Prospective cohort study
Retrospective Studies
Fetus
Rh-Hr Blood-Group System
business.industry
Obstetrics
Pregnancy Outcome
Infant
Gestational age
Hematology
General Medicine
medicine.disease
Female
business
Antibody screening
030215 immunology
Subjects
Details
- ISSN :
- 14230410 and 00429007
- Volume :
- 116
- Database :
- OpenAIRE
- Journal :
- Vox Sanguinis
- Accession number :
- edsair.doi.dedup.....fda3d0e62b1b4f72ec824980f6693b84