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Anti-D administration after childbirth for preventing Rhesus alloimmunisation
1Department of Obstetrics and Gynaecology, University of Adelaide, Women's and Children's Hospital, King William Road, Adelaide, South Australia, Australia, SA 5006. ccrowthe@medicine.adelaide.edu.au
The Cochrane Database of Systematic Reviews
|May 5, 2000
Summary
Postpartum anti-D immunoglobulin significantly reduces RhD alloimmunisation in Rhesus negative mothers. This prophylaxis is effective when given within 72 hours, though optimal dosage requires further study.
Area of Science:
- Immunology
- Obstetrics
- Perinatal Medicine
Background:
- Severe Rhesus D (RhD) alloimmunisation is now rare due to prophylactic anti-D use since the 1970s.
- Rhesus D alloimmunisation poses risks during pregnancy for Rhesus negative women carrying Rhesus positive infants.
Purpose of the Study:
- To systematically review the effects of postpartum anti-D immunoglobulin administration.
- To assess its efficacy in Rhesus negative women without anti-D antibodies who delivered Rhesus positive infants.
Main Methods:
- Systematic review of randomized controlled trials.
- Searched Cochrane Pregnancy and Childbirth Group trials register, Cochrane Controlled Trials Register, and MEDLINE up to January 1999.
- Included trials compared postpartum anti-D immunoglobulin with no treatment or placebo in Rhesus negative women.
Main Results:
- Six trials involving over 10,000 women were analyzed.
- Postpartum anti-D significantly lowered RhD alloimmunisation incidence at six months and in subsequent pregnancies.
- Efficacy was consistent regardless of ABO compatibility and when administered within 72 hours; higher doses showed greater effectiveness.
Conclusions:
- Postpartum anti-D immunoglobulin, given within 72 hours, effectively reduces RhD alloimmunisation risk in Rhesus negative mothers delivering Rhesus positive infants.
- Evidence regarding the optimal dosage of anti-D remains limited.