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• W4387637600 abstract "Anti-D alloimmunization in the first trimester of pregnancy has long been the subject of prevention with anti-D immunoglobulins during events at risk of fetomaternal hemorrhage. Although the efficacy of preventing anti-D alloimmunization by an injection of immunoglobulin at 28 weeks of gestation (WG) is obvious, the literature provides little evidence of the effectiveness before 12+6 WG, several countries have modified their recommendations. In the presumed absence of a difference in alloimmunization risk between early and late prevention, our objective was to evaluate and compare the cost of treatment for three alloimmunization prevention strategies in France, the United Kingdom and the Netherlands. This was a single-center retrospective study. Our target population included all women who received anti-D immunoglobulins (Rhophylac®) in the first trimester of pregnancy before 12+6 WG at Nantes University Hospital in 2018 (N=356). Within the target population, two other populations were constituted on the basis of British (N=145) and Dutch (N=142) clinical practice guidelines (CPG). These three populations were analyzed for comparative cost of treatment for prevention from a health system perspective. The average cost of Rhophylac® alloimmunization prevention for one episode was €117.8 from a health system perspective. The total cost attributed to prevention in 2018 at Nantes University Hospital (N=356) was €41,931.4 according to this perspective. If the UK CPG or Dutch CPG had been applied to the Nantes target population, a saving of around 60% would have been achieved. At the national level, the cost according to the health system perspective specifically attributable to induced abortion (N estimated=26,916) could represent a total cost of €3,170,704. This study highlighted the high cost of the French prevention strategy in the first trimester of pregnancy compared with British or Dutch strategies. The modification of our practices would allow a substantial financial saving to the French health system but would also avoid the non-recommended exposure to a blood product at this term, would allow a faster medical management and a relief of the care system." @default.
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• W4387637600 date "2023-10-01" @default.
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• W4387637600 title "Prevention of Rhesus-D alloimmunization in the first trimester of pregnancy: economic analysis of three management strategies" @default.
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• W4387637600 doi "https://doi.org/10.1016/j.tmrv.2023.150778" @default.
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