Significance of Rh-sensitization during Pregnancy: Its Relation to a Preventive Programme

Godel, John C.; Buchanan, Donald I.; Jarosch, Jean M.; McHugh, M J

doi:10.1136/bmj.4.5629.479

Cited by 30 publications

(10 citation statements)

References 9 publications

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“…Godei et al [4] recorded 29 cases showing antibody at delivery of which 16 were treated with anti-D. Of these 11/14 tested at 6 months postpartum showed no antibody whereas only 4/12 untreated cases tested were negative for antibody. The groups, however, were not strictly compar able as in the treated group 10/16 had only weak antibody compared with 3/13 in the untreated.…”

Section: Discussionmentioning

confidence: 99%

Suppression of Early Rhesus Sensitization by Passive Anti-D Immunoglobulin

Tovey¹,

Scott²

1980

Vox Sanguinis

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Anti-D immunoglobulin is an effective prophylactic against rhesus isoimmunization. It is generally regarded as ineffective once antibody production has developed though there have been a number of inconclusive reports suggesting it may suppress early sensitization. Anti-D (100μg) was given after delivery of a rhesus (D) positive child to a rhesus (D) negative mother who was shown to have anti-D antibodies at that time by five tests on two separate specimens in two different laboratories and by a weakly positive direct anti-globulin test on the cord blood. In a further pregnancy with a rhesus (D) positive child no antibody was detected by multiple tests including enzyme technique.

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Section: Discussionmentioning

confidence: 99%

Suppression of Early Rhesus Sensitization by Passive Anti-D Immunoglobulin

Tovey¹,

Scott²

1980

Vox Sanguinis

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“…The report by Godei et al [2] is extraor dinary in that an extremely sensitive Denzyme treated red cell screening technique [3] was used and the incidence of Rh im munization during pregnancy (5.6%) was three times higher than that in any other series [13]. Later studies from the same centre could not confirm the per sistence of such a high incidence of weak Rh immunization during pregnancy.…”

Section: Resultsmentioning

confidence: 84%

“…The ability of administered RhIG to suppress or reverse early weak Rh immunization is con troversial. Godei et al [2] reported a 5.6% incidence of Rh immunization appearing for the first time in primigravidas during the last trimester of pregnancy. Of the 29 women who became Rh immunized during the 3rd trimester, 24 had Rh antibodies detected RhIG given to each of these women after delivery was not stated.…”

Section: Introductionmentioning

confidence: 99%

Reversal of Rh Alloimmunization

Bowman¹,

Pollock²

1984

Vox Sanguinis

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The Rh Laboratory could find no evidence that Rh immune globulin (RhIG) reduced the incidence of progression of Rh immunization in a clinical study of 36 weakly Rh-immunized women given 300 µg of RhIG at 6-week intervals during pregnancy and after delivery, and in a retrospective study of the natural course of weak Rh immunization in pregnant Rh-negative women not given RhIG and others given RhIG at 28 weeks` gestation and/or after delivery of an Rh-positive baby. Although the failure of about one-third of weakly immunized Rh pregnant women to show any progression of their Rh immunization may be due to relative immune unresponsiveness in some, we believe that most do not have any increase in their Rh immunization because they have no further exposure to Rh-positive fetal red cells. Serial Kleihauer testing of pregnant women at 2-week intervals is being carried out to test this hypothesis.

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“…Early trials in Canada in the late 1960s demonstrated that there was a substantial benefit in providing antenatal RhIG to women at risk for sensitization, with rates of alloimmunization decreasing to zero among treated women (as compared with a rate of 7.2% in an untreated control group) at doses ranging from 145 to 435 mg. 32 These results echoed those of a smaller contemporary trial in which women received RhIG doses in the same range. 33 A recent systematic review of studies evaluating a variety of dosing schemes further established the efficacy of routine antenatal RhIG prophylaxis when given in addition to postnatal dosing, with sensitization rates as high as 2.2% in the control groups and as low as zero among treated women. 34 The authors of this review concluded that the women most likely to benefit from RhIG administration are those with Rh-incompatible fetuses, those who are at risk for sensitization, and those who desire to have additional children.…”

Section: Clinical Efficacymentioning

confidence: 98%