Anti D immunisation



Background

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
  • amniocentesis
  • external cephalic version
  • antepartum haemorrhage
  • ectopic pregnancy
  • abortion
  • caesarian section

Management

  • 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.

Content by Dr Íomhar O' Sullivan 23/06/2000. Reviewed by Dr ÍOS 10/09/2003, 01/05/2005, 14/01/2007. Last review Dr ÍOS 29/08/14.