[New recommendations for the completion of rhesus-immunization prophylaxis with anti-D]

Despite the successful prevention of the Rhesus-isoimmunization in Rhesus-negative mothers after delivery of a Rhesus-positive child by immunoglobulin anti-D injected post partum, some women still get sensitized against the Rhesus-antigen by transplacental haemorrhages occurring during pregnancy or in miscarriages, abortions or ectopic pregnancies. Besides that, failures of the Rhesus-prophylaxis may be caused by large volumes of fetal blood transferred to the maternal circulation - especially in complicated deliveries. We therefore recommend to give immunoglobulin anti-D during pregnancy whenever there is a reported risk of significant transplacental haemorrhages. Further we urge to count the fetal cells in the maternal blood after each delivery to adjust the anti-D-dosage to the volume of the transplacental haemorrhage.