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Related Experiment Video

Updated: Apr 25, 2026

Quantitative Structure-Activity Relationship, Activity Prediction, and Molecular Dynamics of Non-nucleotide Reverse Transcriptase Inhibitors
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Anti-D prophylaxis: past, present and future.

M de Haas, K Finning, E Massey

    Transfusion Medicine (Oxford, England)
    |August 15, 2014
    PubMed
    Summary

    New guidelines clarify anti-D immunoglobulin use in pregnancy, including ectopic pregnancies and caesarean sections. Fetal RHD genotyping can prevent unnecessary prophylaxis for RhD-negative women carrying RhD-negative fetuses.

    Area of Science:

    • Obstetrics and Gynaecology
    • Haematology
    • Immunology

    Background:

    • Routine anti-D prophylaxis (RAADP) is established for preventing Rhesus (Rh) D alloimmunisation in RhD-negative pregnant women.
    • Accurate dosing and identification of immune vs. non-immune anti-D are crucial for effective prophylaxis.
    • Existing guidelines require clarification for specific scenarios like ectopic pregnancy and post-caesarean red cell salvage.

    Purpose of the Study:

    • To provide updated guidance on the use of anti-D immunoglobulin in pregnancy based on new British Committee for Standards in Haematology (BCSH) guidelines.
    • To clarify indications, dosing, and specific clinical situations for anti-D prophylaxis.
    • To explore the role of fetal RHD genotyping in optimizing RAADP.

    Main Methods:

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  • Review and interpretation of the new BCSH guidelines.
  • Discussion of existing data on RAADP efficacy and failure reporting schemes (e.g., Serious Hazards of Transfusion - SHOT).
  • Analysis of the potential impact of fetal RHD genotyping on RAADP strategies.

    • Main Results:

    • The guidelines clarify anti-D use in ectopic pregnancy and after caesarean red cell salvage.
    • Distinguishing immune and non-immune anti-D and appropriate dosing with different preparations are addressed.
    • Fetal RHD genotyping offers a strategy to avoid unnecessary anti-D administration to RhD-negative women with RhD-negative fetuses.

    Conclusions:

    • Updated BCSH guidelines offer crucial clarifications for anti-D immunoglobulin use in pregnancy.
    • Implementation of RAADP requires careful auditing and scrutiny, potentially aided by reporting schemes.
    • Fetal RHD genotyping presents a significant advancement for targeted RAADP, with economic evaluations underway.