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Prevention of Rh alloimmunization.

Karen Fung Kee Fung, Erica Eason, Joan Crane

    Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'Obstetrique Et Gynecologie Du Canada : JOGC
    |September 13, 2003
    PubMed
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    This guideline provides recommendations for using anti-D immunoglobulin (Ig) to prevent Rh alloimmunization in Canadian women. Adherence to these guidelines can decrease Rh alloimmunization and standardize immunoprophylaxis practices.

    Area of Science:

    • Obstetrics and Gynecology
    • Immunology
    • Maternal-Fetal Medicine

    Background:

    • Rh alloimmunization poses a risk to Rh-negative women carrying Rh-positive fetuses.
    • Standardized guidelines are needed to optimize anti-D prophylaxis and minimize practice variation.

    Framework:

    • Evidence-based review of English-language articles from 1968-2001.
    • Quantified using Canadian Task Force on Periodic Health Exam guidelines.
    • Reviewed by the Society of Obstetricians and Gynaecologists of Canada (SOGC) committees.

    Implementation:

    • Specific dosing and timing recommendations for anti-D Ig postpartum, antepartum, and after obstetric events (e.g., miscarriage, abortion, amniocentesis).
    • Routine screening for alloantibodies and consideration of paternal Rh testing.

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  • Guidelines for managing fetomaternal hemorrhage (FMH) and "weak D" phenotypes.
  • Implications:

    • Reduced incidence of Rh alloimmunization in Canadian women.
    • Minimized variation in immunoprophylaxis strategies.
    • Improved management of Rh-negative pregnancies.