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Reduction of Rh0(D) sensitization: a cost-effective analysis.

O W Lim, A A Fleisher, H K Ziel

    Obstetrics and Gynecology
    |April 1, 1982
    PubMed
    Summary

    The first US study found a 1.0% incidence of gestational Rh0(D) sensitization. Prophylactic Rh0(D) immune globulin (RhoGAM) at 28 weeks gestation is the most cost-effective prevention method.

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    Area of Science:

    • Obstetrics and Gynecology
    • Immunology
    • Public Health

    Background:

    • Rh0(D) sensitization poses a significant risk during pregnancy.
    • Previous studies on gestational sensitization incidence in the US were limited.
    • Understanding sensitization rates is crucial for effective prevention strategies.

    Purpose of the Study:

    • To determine the incidence of gestational Rh0(D) sensitization in a large US population.
    • To analyze the cost-effectiveness of different Rh0(D) prevention strategies.
    • To evaluate the efficacy of Rh0(D) immune globulin (RhoGAM) administration.

    Main Methods:

    • Retrospective analysis of 3995 Rh0(D)-negative pregnancies from 40,319 deliveries (1976-1978).
    • Identification of gestational sensitization cases and RhoGAM failures.
    • Cost-effectiveness analysis of prophylactic RhoGAM at 28 weeks gestation versus postpartum administration and Fetaldex testing.

    Main Results:

    • The incidence of gestational Rh0(D) sensitization was 1.0% (21 out of 2098 pregnancies).
    • Of 61 sensitized pregnancies, 38 had prior sensitization, 21 were gestational, and 2 were RhoGAM failures.
    • Prophylactic RhoGAM at 28 weeks gestation was identified as the most cost-effective prevention method.

    Conclusions:

    • Gestational Rh0(D) sensitization occurs at a notable rate, necessitating effective prevention.
    • Administering prophylactic Rh0(D) immune globulin (RhoGAM) at 28 weeks gestation is the most cost-effective strategy.
    • Universal RhoGAM administration to Rh0(D)-negative mothers with Rh0(D)-positive fetuses is essential.

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