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• W5545513 abstract "Editor—In his editorial van Dijk advocates routine antenatal prophylaxis with anti-D immunoglobulin of all pregnant women who are RhD negative and refers to the consensus conference at the Royal College of Physicians in Edinburgh in April 1997.1 He states that two dose schedules were considered—two doses of 500 IU of anti-D immunoglobulin, one at 28 weeks’ gestation and the other at 34 weeks, and one dose of 1000 IU given between 28 and 30 weeks—both options being equally effective. He implies that the second option reflects Bowman’s practice in Canada.2 Bowman’s programme in fact uses a dose of 1500 IU given at 28 weeks; maternal anti-D immunoglobulin concentrations are then monitored and additional anti-D immunoglobulin is given at around 36 weeks to those women in whom passive anti-D immunoglobulin is no longer detectable. In my presentation to the conference the second option considered was a single dose of 1500 IU—not 1000 IU—of anti-D immunoglobulin at 30 weeks. In the final consensus statement the panel did not indicate a preference between these options and was satisfied that “both seem to work.” A dose of 1000 IU of anti-D immunoglobulin was never considered as the rate of its decay would mean that little or none would remain in a woman’s circulation towards the end of pregnancy, when fetomaternal haemorrhage is known to occur more frequently. Revised guidelines on the use of anti-D immunoglobulin from the British Blood Transfusion Society and the Royal College of Obstetricians and Gynaecologists agree that the preferred option is two doses of 500 IU of anti-D immunoglobulin.3 This option was chosen partly because it uses less anti-D immunoglobulin—a scarce resource—than a single dose of 1500 IU and partly because two doses of 500 IU given at 28 and 34 weeks achieve a higher circulating concentration of anti-D immunoglobulin as term approaches than does the single larger dose. The revised guidelines were also prompted by the absence of published data on the clinical outcome of giving a single dose of 1500 IU at 30 weeks." @default.
• W5545513 created "2016-06-24" @default.
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• W5545513 date "1998-05-23" @default.
• W5545513 modified "2023-09-23" @default.
• W5545513 title "Preventing RhD haemolytic disease of the newborn" @default.
• W5545513 cites W1868283005 @default.
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• W5545513 doi "https://doi.org/10.1136/bmj.316.7144.1611" @default.
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