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Compliance with postpartum Rh isoimmunization prophylaxis in Alberta.

S Huchcroft, P Gunton, T Bowen

    CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne
    |November 1, 1985
    PubMed
    Summary

    Compliance with postpartum Rh immune globulin (RhIG) prophylaxis was high in Alberta, with 93.6% of eligible Rh-negative women receiving RhIG. However, compliance varied significantly based on obstetric circumstances.

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    Area of Science:

    • Obstetrics and Gynecology
    • Immunology
    • Public Health

    Background:

    • Rh isoimmunization remains a significant concern in pregnancy.
    • Effective prophylaxis, Rh immune globulin (RhIG), is crucial for preventing hemolytic disease of the newborn.
    • Assessing compliance with established prophylaxis protocols is essential for optimizing maternal and infant outcomes.

    Purpose of the Study:

    • To determine the compliance rate with postpartum Rh isoimmunization prophylaxis in Alberta.
    • To evaluate the administration of Rh immune globulin (RhIG) among eligible Rh-negative women.
    • To identify factors influencing compliance with RhIG prophylaxis.

    Main Methods:

    • A retrospective review of obstetric records from two major Calgary hospitals in 1979.

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  • Analysis of 4528 women's charts, focusing on Rh-negative status and RhIG administration.
  • Calculation of prevalence rates and compliance percentages based on eligibility criteria.

    • Main Results:

    • The prevalence of Rh negativity was 16% among the reviewed population.
    • Of 710 Rh-negative women, 490 (69%) were eligible for RhIG; 93.6% received it.
    • Compliance was highest for postpartum diagnoses (98.2%) and lowest for obstetric emergencies (66.7%).
    • Rh type was not determined in over half (54.7%) of women undergoing amniocentesis.

    Conclusions:

    • High compliance with postpartum RhIG administration was observed, particularly for routine postpartum cases.
    • Lower compliance in obstetric emergencies highlights areas for potential improvement in prophylaxis delivery.
    • The study underscores the importance of maximizing compliance with cost-effective postpartum programs before widespread antepartum implementation.