USE OF DIFFERENT DOSES OF ANTI-RH IgG IN THE PREVENTION OF RH ISOIMMUNISATION

Buchanan, Donald I.; Bell, R. Edward; Beck, R; Taylor, Walter C.

doi:10.1097/00006254-197002000-00009

Cited by 1 publication

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“… A Western Canadian Trial : Primary study: Chown 1969; Other publications not used: Buchanan 1969 [ 45 ], Godel 1968 [ 46 ] B Combined Study (England and Baltimore) : Primary study: No author listed 1971 [ 34 ]; Other publications not used: Clarke 1965 [ 47 ], Clarke 1968 [ 48 ], Finn 1968 [ 49 ], Woodrow 1965 [ 50 ], No author listed 1966 [ 51 ] C International trial : Primary study: White 1970 [ 38 ]; Subgroup data for dosage taken from Ascari 1968 [ 31 ]; Other publications not used: Ascari 1969 [ 52 ], Bishop 1968 [ 53 ], Bishop 1969 [ 54 ], Bryant 1969 [ 55 ], Freda 1966 [ 56 ], Freda 1967 [ 57 ], Jennings 1968 [ 58 ], Pollack 1968 [ 59 ], Robertson 1968 [ 60 ], Robertson 1969 [ 61 ], Stenchever 1970 [ 62 ], Symposium 1971 [ 63 ] D Part of the Combined study, but reports only on those with <0.2 ml of Rh-positive fetal blood in their circulation. All other Combined study publications do not include these women.…”

Section: Resultsmentioning

confidence: 99%

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Antenatal and postpartum prevention of Rh alloimmunization: A systematic review and GRADE analysis

et al. 2020

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Background Existing systematic reviews of Rh immunoprophylaxis include only data from randomized controlled trials, have dated searches, and some do not report on all domains of risk of bias or evaluate the certainty of the evidence. Our objective was to perform an updated review, by including new trials, any comparative observational studies, and assessing the certainty of the evidence using the GRADE framework. Methods We searched MEDLINE, Embase and the Cochrane Library from 2000 to November 26, 2019. Relevant websites and bibliographies of systematic reviews and guidelines were searched for studies published before 2000. Outcomes of interest were sensitization and adverse events. Risk of bias was evaluated with the Cochrane tool and ROBINS-I. The certainty of the evidence was performed using the GRADE framework. Results Thirteen randomized trials and eight comparative cohort studies were identified, evaluating 12 comparisons. Although there is some evidence of beneficial treatment effects (e.g., at 6months postpartum, fewer women who received RhIg at delivery compared to no RhIg became sensitized [70 fewer sensitized women per 1,000 (95%CI: 67 to 71 fewer); I 2 = 73%]), due to very low certainty of the evidence, the magnitude of the treatment effect may be overestimated. The certainty of the evidence was very low for most outcomes often due to high risk of bias (e.g., randomization method, allocation concealment, selective reporting) and imprecision (i.e., few events and small sample sizes). There is limited evidence on prophylaxis for invasive fetal procedures (e.g. amniocentesis) in the comparative literature, and few studies reported adverse events.

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