BCSH guideline for the use of anti-D immunoglobulin for the prevention of haemolytic disease of the fetus and newborn

摘要

Prior to the availability of anti-D immunoglobulin (anti-D Ig), the incidence of Rh D alloimmunisation in D negative women following two deliveries of D positive, ABO-compatible, infants was approximately 16%, and haemolytic disease of the fetus and newborn (HDN) due to anti-D was a significant cause of morbidity and mortality (Urbaniak & Greiss, 2000). Following routine post-partum administration of anti-D Ig, the rate of alloimmunisation dropped to approximately 2%. A further reduction in the sensitisation rate ranging from 0-17 to 0-28% was achieved by introducing routine antenatal prophylaxis during the third trimester of pregnancy (Tovey et al, 1983a,b; Huchet et al., 1987; Mayne et al, 1997; MacKenzie et al, 1999). Associated with this reduction in sensitisation is a reduction in mortality associated with HDN, from 46/100 000 births to 1-6/100 000 births (Pilgrim et al, 2009).