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Rh isoimmunization, Manitoba, 1963-75.

J M Bowman, B Chown, M Lewis

Canadian Medical Association Journal

|February 5, 1977

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Rh immune globulin significantly reduced Rh-isoimmunized pregnancies and perinatal deaths in Manitoba. Universal Rh testing and antenatal prophylaxis are crucial for complete prevention of Rh erythroblastosis.

Area of Science:

Obstetrics and Gynecology
Immunology
Perinatal Medicine

Background:

Rh-isoimmunized pregnancies pose significant risks to newborns, historically leading to high perinatal mortality.
The introduction of Rh immune globulin aimed to prevent Rh sensitization in Rh-negative mothers.

Purpose of the Study:

To evaluate the impact of Rh immune globulin on Rh-isoimmunized pregnancies and associated perinatal mortality in Manitoba.
To identify factors contributing to Rh isoimmunization despite the availability of Rh immune globulin.

Main Methods:

Retrospective analysis of Rh-isoimmunized pregnancies and perinatal mortality rates in Manitoba over two decades (1963-1975).
Analysis of cases of Rh isoimmunization to determine the reasons for failure to prevent sensitization.

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Main Results:

A substantial decrease in Rh-isoimmunized pregnancies from 10.0-10.6 per 1000 births (1963-1964) to 3.4-3.5 per 1000 births (1974-1975).
Perinatal mortality rates decreased from 13.8-15.7% to 0-2.2%, with a reduction in perinatal deaths from 55 to 1.
Key reasons for isoimmunization included missed postpartum (33 cases) and antenatal (48 cases) Rh immune globulin administration.

Conclusions:

Rh immune globulin has been highly effective in reducing Rh isoimmunization and perinatal deaths.
Universal prenatal and postpartum Rh testing, coupled with antenatal prophylaxis, is essential for complete prevention of Rh isoimmunization and Rh erythroblastosis.