Can we safely stop testing for Rh status and immunizing Rh-negative women having early abortions? A comparison of Rh alloimmunization in Canada and the Netherlands

Wiebe, Ellen; Campbell, Mackenzie; Aiken, Abigail R.A.; Albert, Arianne

doi:10.1016/j.conx.2018.100001

Cited by 20 publications

(21 citation statements)

References 12 publications

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“…Recent research has suggested that the risk of Rh sensitization after early abortion is negligible [34][35][36]. Consequently, the National Abortion Federation has concluded that forgoing Rh typing and administration of anti-D immunoglobulin is reasonable for Rh-negative patients having aspiration abortion before 56 days of gestation and may be considered for all patients having MA at less than 70 days [16,37].…”

Section: Rh Typing and Other Pre-treatment Laboratory Testingmentioning

confidence: 99%

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

et al. 2020

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Section: Rh Typing and Other Pre-treatment Laboratory Testingmentioning

confidence: 99%

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

et al. 2020

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“…The committee recruited to develop the 2019 NICE guideline on abortion care1 noted that there was significant variation between different international and national guidelines in this area, with most Scandinavian countries not recommending anti-D for medical abortion until 8–12 weeks' gestation but with other countries recommending its use in all abortions 11–17. Epidemiological data comparing isoimmunisation rates in the Netherlands, where anti-D is not given to miscarriages under 10 weeks or abortions under 7 weeks, with Canada where anti-D is routinely administered showed that the prevalence of clinically significant antibodies was lower in the Netherlands 18. The American National Abortion Federation has recently recommended not testing or administering anti-D for any abortion under 8 weeks, and to consider not doing so for medical abortions under 10 weeks 19…”

Section: Discussionmentioning

confidence: 99%

Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13⁺⁶weeks’ gestation: a systematic review and new NICE consensus guidelines

Schmidt‐Hansen

Lord

Hawkins

et al. 2020

BMJ Sex Reprod Health

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BackgroundIn order to develop the 2019 National Institute for Health and Care Excellence (NICE) national guideline on abortion care for the National Health Service1 we undertook a systematic review comparing anti-D prophylaxis to no prophylaxis in rhesus D (RhD)-negative women undergoing medical or surgical abortion of pregnancy at ≤13+6 weeks’ gestationMethodsWe searched Embase, Medline and the Cochrane Library on 19 October 2018. We also consulted experts and checked reference lists for any missed trials. Eligible studies were randomised controlled trials and non-randomised comparative studies, published in English from 1985 onwards, comparing anti-D prophylaxis to no anti-D prophylaxis in RhD-negative women undergoing medical or surgical abortion at ≤13+6 weeks’ gestation, and reporting subsequent anti-D isoimmunisation/sensitisation or subsequent affected pregnancy. These outcomes were to be analysed as risk ratios in Review Manager 5.3 using the Mantel-Haenszel statistical method and a fixed or random effect model. The overall quality of the evidence was planned to be assessed using GRADE.ResultsThe search identified 426 potentially relevant studies of which none met the inclusion criteria. Recommendations for practice were therefore based on the clinical expertise of the guideline committee.Conclusions(1) Offer anti-D prophylaxis to women who are Rhesus D negative who are having an abortion after 10+0 weeks’ gestation. (2) Do not offer anti-D prophylaxis to women who are having a medical abortion up to and including 10+0 weeks’ gestation. (3) Consider anti-D prophylaxis for women who are rhesus D negative and are having a surgical abortion up to and including 10+0 weeks’ gestation.

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“…17 Patients receiving a medical or surgical abortion should be offered Rh status testing and receive Rh immunoglobulin if found to be Rh negative, although there is emerging evidence that patients at 8 weeks' gestation and earlier do not need Rh immunoglobulin. 11,18,19 If patients have an intrauterine device in place, it must be removed before initiation of medical abortion. 11 There is currently insufficient evidence to recommend routine prophylactic antibiotics for medical abortions, and current practices vary, with some clinics opting to provide prophylactic antibiotics.…”

Section: Definitions Medical Abortionmentioning

confidence: 99%

Management of Postabortion Complications for the Emergency Medicine Clinician

Orlowski

Soares

Kerrigan

et al. 2021

Annals of Emergency Medicine

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Although induced abortion is generally a safe outpatient procedure, many patients subsequently present to the emergency department, concerned about a postabortion complication. It is helpful for emergency physicians to understand the medications and procedures used in abortion care in the United States to effectively and efficiently triage and treat women presenting with potential complications from an abortion. Furthermore, because many states are experiencing increased abortion restrictions that limit access to care, emergency medicine physicians may encounter more patients presenting after self-managed abortions, which presents additional challenges. This article reviews the epidemiology and background of abortion care, including the range of symptoms and adverse effects that are within the scope of an uncomplicated procedure. This review also offers a comprehensive overview of management of abortion complications, including algorithms for more common complications and descriptions of less common but more severe adverse events. The article concludes with a recognition of the social stigma and legal regulations unique to abortion care. [

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Can we safely stop testing for Rh status and immunizing Rh-negative women having early abortions? A comparison of Rh alloimmunization in Canada and the Netherlands

Cited by 20 publications

References 12 publications

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13⁺⁶weeks’ gestation: a systematic review and new NICE consensus guidelines

Management of Postabortion Complications for the Emergency Medicine Clinician

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Can we safely stop testing for Rh status and immunizing Rh-negative women having early abortions? A comparison of Rh alloimmunization in Canada and the Netherlands

Cited by 20 publications

References 12 publications

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

Commentary: No-test medication abortion: A sample protocol for increasing access during a pandemic and beyond

Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13+6weeks’ gestation: a systematic review and new NICE consensus guidelines

Management of Postabortion Complications for the Emergency Medicine Clinician

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Product

Resources

About

Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13⁺⁶weeks’ gestation: a systematic review and new NICE consensus guidelines