The following recommendations for the use of Anti-D immunoglobulin were made by the UK National Blood Transfusion Service Working Party in 1991.
Use during pregnancy:
The following episodes may be associated with significant foeto-maternal haemorrhage during pregnancy
- Abdominal trauma(Rh negative women only)
- chorionic villus sampling
- external cephalic version
- antepartum haemorrhage
- ectopic pregnancy
- caesarian section
- 250iu should be given before each episode before 20 weeks gestation and 500iu should be given for episodes occurring after 20 weeks gestation in conjunction with a Kleihauer test.
- Anti-D should be administered to all Rhesus Negative women experiencing an episode unless the fetus is definitely known to be Rhesus Negative.
- Anti-D should be given to all Rhesus Negative women with either a threatened abortion or spontaneous complete abortion after 12 weeks gestation.
- Intermittent bleeding should be treated with further injections of Anti-D at 6-weekly intervals until delivery.
- Before 12 weeks gestation, where an episode of vaginal bleeding has occurred and the pregnancy apparently remains viable, a Rhesus Negative mother must be given Anti-D immunoglobulin.