[Intravenous administration of anti-D hyperimmunoglobulin after mismatched transfusion (author's transl)].

620 ml of 0 Rh-positive blood (310 ml CCD.ee + 310 ml CcD.EE) were administered to a 27-year-old 0 Rh-negative (ccddee) woman in connection with an emergency curettage. 16 hours after this mismatched transfusion an intravenous infusion of anti-D hyperimmunoglobulin was started: 8000 mug (13 mug/ml blood) were given within 14 hours (570 mug/h) under strict supervision. The 10% immunoglobulin preparation had been diluted 20 times. There were only slight variations in heart rate and blood pressure, slight fever and mild increase in serum bilirubin after the infusion. There was slight haemoglobinuria in one urine sample, but no signs of kidney damage. The direct Coombs test was slightly positive after two days, negative after four and six days. The indirect Coombs test was negative after six months. The patient has not become pregnant since. Slow intravenous infusion of highly diluted anti-D hyperimmunoglobulin, under strict clinical supervision, is probably appropriate for Rh prophylaxis after transfusion mismatch. The dose of 13 mug/ml could probably be considerably reduced. 250 mug anti-D per hour should not be exceeded.