Evidence to support the single-dose over the two-dose protocol for routine antenatal anti-D Rhesus prophylaxis: a...

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Public Health

Background:

• Routine antenatal anti-D prophylaxis (RAADP) is crucial for RhD negative women to prevent hemolytic disease of the newborn.
• Current protocols often involve single or two-dose regimens, with varying compliance rates.
• Optimizing RAADP administration is essential for maternal and fetal health outcomes.

Purpose of the Study:

• To compare the compliance and effectiveness of a single-dose versus a two-dose protocol for RAADP.
• To evaluate the impact of different RAADP protocols on timely administration during pregnancy.
• To identify potential benefits of the single-dose protocol in terms of RhD sensitisation and resource utilization.

Main Methods:

• A prospective observational study was conducted in a district teaching hospital.
• The study reviewed obstetric records of 644 eligible RhD negative women.
• Compliance with RAADP administration at specific gestational ages was assessed for single-dose and two-dose protocols.

Main Results:

• No significant difference in the 28-week injection compliance between single-dose (98%) and two-dose (95%) protocols.
• Overall compliance at the correct gestation (28 ± 1 weeks) was similar for both protocols (78% vs. 77%).
• The single-dose protocol demonstrated significantly greater overall success in timely RAADP administration compared to the two-dose protocol (P=0.021).

Conclusions:

• The single-dose RAADP protocol offers enhanced compliance and adherence compared to the two-dose protocol.
• This improved compliance has the potential to reduce RhD sensitisation rates.
• Further improvements in administering RAADP at the correct gestation are still needed, but the single-dose approach shows promise for economic and manpower benefits.