Total prevention of Rh hemolytic disease: possible or impossible?

Rh immune globulin prophylaxis has reduced the incidence of Rh immunization in Manitoba from 10.6 per 1000 births in 1964 to 1.8 per 1000 births in 1979. With total physician, patient compliance, and universal antenatal, postnatal postabortion, postamniocentesis Rh prophylaxis programs and Kleihauer fetal red cell screening, the incidence of Rh immunization will be reduced even further. However, since there is a 0.106% incidence of Rh immunization appearing before antenatal Rh prophylaxis is given and a 0.085% incidence of Rh immunization occurring in which the cause of the immunization is unknown, total prevention of Rh immunization is impossible. Assuming a family size of 2.2 to 2.5 children, reduction of the incidence of Rh immunization to 0.4 per 1000 births is possible and should be our goal.