To try and identify those women at possible risk of Rh immunization during pregnancy and so limit ante-partum treatment to them, 558 smears from 140 women were examined for fetal cells. Those found to have more than an estimated 0.05 ml of fetal blood were then given Rh IgG. Two of 134 untreated women and one of six treated women became immunized. The reason for the latter failure is uncertain. The total frequency of immunization, 2.2%, does not differ from that expected in the absence of treatment.
After 16-32 months in solution at 4°C, ultracentrifuge and immunoelectrophoresis assays of five lots of low protein Rh IgG protein concentrations 3.9, 5.8, 4.1, 3.4 and 3.1%, revealed each lot to consist of a single unaggregated and unfragmented protein with an s20^w constant of 6.5-7.3. The lots were 94.0-98.5% pure IgG. Autoanalyzer studies demonstrated no loss of anti-D for 16-37 months except in one lot stable at 20 months which showed a drop from 363 to 298 μg/ml at 26 months. 125I antiglobulin measurements revealed a 23- to 40-percent early loss of anti-D with stability thereafter. Low protein Rh IgG cleared Rh-positive cells from 11 Rh-negative volunteers and protected 2,093 Rhnegative women at risk of Rh immunization at least as effectively as standard Rh IgG. Low protein Rh IgG is a pure, stable, active, protective and economical agent for use in Rh prophylaxis.
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