OBJECTIVE: To ascertain whether anti-D immunoglobulin is being administered to Rhesus D negative women in accordance with the 1991 recommendations for its use to cover all events which may result in fetomaternal haemorrhage. DESIGN: The notes of women delivered in 1994 were examined for compliance with the 1991 recommendations. SETTING: Seven maternity units using a central antenatal screening service. PARTICIPANTS: Nine hundred and twenty-two Rhesus D negative women delivered in these seven hospitals. MAIN OUTCOME MEASURES: The prescription, dosage and indications for administration of anti-D immunoglobulin to women during pregnancy and in the puerperium. RESULTS: Postnatal anti-D immunoglobulin was given in appropriate doses to more than 95% of women who required it. Omissions mainly arose from confusion among women who recently had received antenatal treatment with anti-D immunoglobulin. The 1991 recommendations for antenatal administration were less closely followed. Abdominal trauma was covered in only 20% of cases. An inadequate dosage of 250 i.u. was given to 25 women for antepartum haemorrhage after 20 weeks of gestation. The purpose of the Kleihauer test was sometimes poorly understood, with a 'negative' result interpreted as a reason not to give anti-D immunoglobulin. CONCLUSION: Closer adherence to the 1991 recommendations might further reduce the incidence of Rhesus D immunisation below the current 1%. It is suggested that more careful application of the recommendations should be evaluated before considering either routine antenatal prophylaxis, or the European recommendation of a larger dose (1000-1500 i.u.), both of which would increase the requirements for this limited resource.
OBJECTIVE: To ascertain whether anti-D immunoglobulin is being administered to Rhesus D negative women in accordance with the 1991 recommendations for its use to cover all events which may result in fetomaternal haemorrhage. DESIGN: The notes of women delivered in 1994 were examined for compliance with the 1991 recommendations. SETTING: Seven maternity units using a central antenatal screening service. PARTICIPANTS: Nine hundred and twenty-two Rhesus D negative women delivered in these seven hospitals. MAIN OUTCOME MEASURES: The prescription, dosage and indications for administration of anti-D immunoglobulin to women during pregnancy and in the puerperium. RESULTS: Postnatal anti-D immunoglobulin was given in appropriate doses to more than 95% of women who required it. Omissions mainly arose from confusion among women who recently had received antenatal treatment with anti-D immunoglobulin. The 1991 recommendations for antenatal administration were less closely followed. Abdominal trauma was covered in only 20% of cases. An inadequate dosage of 250 i.u. was given to 25 women for antepartum haemorrhage after 20 weeks of gestation. The purpose of the Kleihauer test was sometimes poorly understood, with a 'negative' result interpreted as a reason not to give anti-D immunoglobulin. CONCLUSION: Closer adherence to the 1991 recommendations might further reduce the incidence of Rhesus D immunisation below the current 1%. It is suggested that more careful application of the recommendations should be evaluated before considering either routine antenatal prophylaxis, or the European recommendation of a larger dose (1000-1500 i.u.), both of which would increase the requirements for this limited resource.
Authors: H Howard; V Martlew; I McFadyen; C Clarke; J Duguid; I Bromilow; J Eggington Journal: Arch Dis Child Fetal Neonatal Ed Date: 1998-01 Impact factor: 5.747
Authors: Trina M Fyfe; M Jane Ritchey; Christorina Taruc; Daniel Crompton; Brian Galliford; Rose Perrin Journal: BMC Pregnancy Childbirth Date: 2014-12-10 Impact factor: 3.007