A case for the antenatal administration of anti-D immunoglobulin to primigravidae

Abstract

The value and practicability of introducing an antenatal anti-D immunoglobulin programme is a matter of controversy. Those in favour of the programme claim it is the only procedure available which will reduce still further the incidence of Rh sensitisation. Opponents claim it is not cost-effective. An analysis of data collected in the Yorkshire region points to the value of at least giving anti-D antenatally to all Rh-negative primigravidae and, if the baby is found to be Rh-negative, administering anti-D antenatally in the second pregnancy. Mothers developing anti-D antibodies in their first Rh-positive pregnancy are major contributors to the number of infant deaths due to Rh haemolytic disease of the newborn. When anti-D immunoglobulin is given to a mother with no demonstrable antibodies and she develops Rh antibodies in her next Rh-positive pregnancy, the prognosis for the child is good and "failures of protection" of anti-D immunoglobulin rarely result in infant deaths due to Rh antibodies.