RhD IMUNOPROPHILAXIS

Authors

  • Branislava Belić Department of Veterinary Medicine, Faculty of Agriculture, University of Novi Sad, Novi Sad, Serbia

DOI:

https://doi.org/10.46793/PP170220006B

Keywords:

RhD immunoprophylaxis, anti-D antibodies, pregnancy, abortion, childbirth

Abstract

Currently problems related to RhD antigen immunisation have been minimized in comparison to 45 years ago, mainly due to preventive administration of anti-D immunoglobulin. The beginning of systematic Rh protection in the US and the UK was 1969 while in our country started to be implemented from 1970. The paper presents problems related to the creation Anti D antibodies for the implementation of immunoprophylaxis and reducing immunization RhD negative women with RhD antigen. Special attention was given to the recommendations for RhD immunoprophylaxis in the case of abortion, invasive diagnostic and therapy procedures, in postnatal and antenatal immunoprophylaxis. We discribed two approaches for the implementation of antenatal RhD immunoprophylaxis. The antenatal Rh protection and enforcement of anti-D Ig after immunization events in pregnancy are two completely separate issues. Immunohaematological testing during pregnancy and after childbirth have been described together with significance and the effect of anti-D immunoglobulin. Consequences of RhD antenatal care for bearing mother and fetus until now have not been proven and there is no evidence that the application of PR protection can lead to adverse reactions in the mother and fetus. RhD immunoprophylaxis in the Republic of Serbia since the seventies have been routinely administered during pregnancy and after childbirth, while antenatal RhD immunoprophylaxis has been  applied, but not sistematicaly. It is of utmost importance to establish regulations on prenatal prevention.

References

Jovanović-Srzentić S., Antić A., Radonjić Z.:Imunohematološka dijagnostika aloimunizacija u trudnoći.Udruženje transfuziologa Srbije, 2016.

Mollison PL, Engelfriet CP,Contreras:M.Haemolytic disease of the fetus and newborn. In: Mollinson PL, editor.Blood Transfusion in Clinical Medicine.10th Edition.Oxford: Blackwell Scientific; 1997.p. 414.

Tovey, L.A.D. Towards the conquest of Rh haemolytic disease: Britain’s contribution and the role of serendipity. Transfusion Medicine,1992;2: 99-109.

S. Plešinac, J. Lukić, D. Plećaš, D. Topalov: Određivanje RhD faktora ploda iz krvi majke. Bilten za transfuziologiju 2014; 60 (1-2): 46-49.

Huchet, J., Dallemagne, S., Huchet, C., Brossard, Y., Larsen, M., Parnet-Mathieu., F. [Ante-partum administration of preventive treatment of Rh-D immunisation in rhesus-negative women.Parallel evaluation of transplacental passage of fetal blood cells. Results of a multicentre study carried out in the Paris region]. J Gynecol Obstet Biol Reprod 1987; 16: 101-111.

Chitty LS, Finning, K, Wade, A, Soothill P, Martin B, Oxenford K, Daniels G, Massey E. Diagnostic accuracy of routine antenatal determination of fetal RHD status across gestation: population based cohort study. BMJ 2014; 349: g5243.

Clausen FB, Christiansen M, Steffensen R,Jørgensen S, Nielsen C, Jakobsen MA, et al.Report of the first nationally implemented clinical routine screening for fetal RHD in D− pregnant women to ascertain the requirement for antenatal RhD prophylaxis.Transfusion 2012; 52: 752–8.

Soothill P, Finning K, Latham T, Wreford-Bush T, Ford J, Daniels G. Use of cffDNA to avoid administration of anti-D to pregnant women when the fetus is RhD-negative: implementation in the NHS. British Jour of Obstetr & Gynaecol 2014; 122(12):1682-6.

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Published

04/28/2017

Issue

Section

Review Articles