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Implementation of the rhesus prevention programme: a prospective study

S Ghosh1, W G Murphy

  • 1Scottish National Blood Transfusion Service, Edinburgh.

Scottish Medical Journal
|October 1, 1994
PubMed
Summary
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This study assessed the RhD prevention program in Scotland. Findings indicate a need for improved awareness and compliance with anti-D administration following potentially immunizing events during pregnancy.

Area of Science:

  • Obstetrics and Gynecology
  • Immunology
  • Public Health

Background:

  • Rhesus (RhD) disease is a condition where a pregnant woman who is RhD-negative develops antibodies against the RhD-positive blood of her fetus.
  • The RhD prevention program, involving anti-D immunoglobulin administration, aims to prevent RhD alloimmunization.
  • Assessing the completeness of this program is crucial for maternal and fetal health outcomes.

Purpose of the Study:

  • To evaluate the completeness of anti-D immunoglobulin administration within the rhesus prevention program.
  • To identify areas for improvement in the program's implementation and compliance.
  • To assess the appropriate use of Kleihauer testing in managing potentially immunizing events.

Main Methods:

  • Retrospective study of RhD-negative women who completed pregnancy between January and August 1992 in two Scottish regions.

Related Experiment Videos

  • Review of records for anti-D administration following antenatal events and at birth.
  • Analysis of Kleihauer testing instances after 20 weeks gestation.

    • Main Results:

    • Out of 1120 RhD-negative women with RhD-positive or unknown fetal blood type pregnancies, anti-D administration records were missing for eight.
    • Anti-D was administered in 69.6% of recorded antenatal events requiring it.
    • Kleihauer testing was performed in only 9 of 98 instances of antepartum hemorrhage after 20 weeks gestation.

    Conclusions:

    • There is a need to enhance awareness regarding the necessity of anti-D administration after potentially immunizing events during pregnancy.
    • Compliance with postnatal anti-D administration requires improvement in specific study regions.
    • Re-evaluation of current recommendations for Kleihauer testing following antenatal anti-D administration after 20 weeks gestation is warranted.