Should anti-D immunoglobulin be given antenatally?

A survey of 246 Rh-negative expectant mothers who had Rh antibodies for the first time has shown that in about 50% sensitisation might have been prevented had anti-D immunoglobulin (Ig) been injected after delivery of the previous Rh-positive baby. Sensitisation of the other mothers could have been prevented only by giving anti-D Ig antenatally during pregnancy. Perinatal mortality and morbidity in Britain from Rh-haemolytic disease in first-affected babies is now so low that an attempt to eliminate Rh-haemolytic disease by giving anti-D Ig to all expectant Rh-negative mothers during the antenatal period is not cost effective. If all Rh-negative mothers who abort or give birth to an Rh-positive baby are injected with an adequate dose of anti-D Ig within 72 h of delivery, the small number of mothers in whom measures to prevent sensitisation have failed can be reduced by 50%.