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A review of maternal alloimmunisation to Rh D in Northern Ireland
Author(s) -
McCauley C. J.,
Morris K.,
Maguire K.
Publication year - 2017
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/tme.12387
Subject(s) - medicine , incidence (geometry) , pediatrics , haemolytic disease , retrospective cohort study , northern ireland , pregnancy , antibody , obstetrics , fetus , immunology , history , ethnology , physics , biology , optics , genetics
SUMMARY Objectives To estimate the current incidence of maternal sensitisation to Rhesus (Rh) D in Northern Ireland, examine adherence to recommendations for administration of anti‐D immunoglobulin and identify potential causes for all cases of anti‐D alloimmunisation sensitisation from January 2010 to September 2015. Background Post‐partum anti‐D immunoglobulin administered to Rh D‐negative women and routine antenatal anti‐D prophylaxis have greatly reduced the incidence of haemolytic disease of the fetus and newborn due to immune anti‐D. Despite these measures, anti‐D alloimmunisation sensitisation continues to occur, albeit much less frequently than in the past. Methods/Materials This was a retrospective review of new sensitisations to Rh D detected in antenatal records between January 2010 and September 2015 in Northern Ireland. A review of patient notes and laboratory data was carried out to examine adherence to standards and identify potential causes of sensitisation. Results A total of 67 new sensitisations to Rh D were identified over a 69‐month period, and the sensitisation rate for the full calendar years 2010–2014 was 0·310%. Only 4% of cases appear to have been preventable, with two cases involving failure to adhere to guidelines. Conclusion A total 96% of sensitisations occurred despite full compliance with guidelines. In a large proportion, sensitisation occurred following delivery (51%). A change in practice in Northern Ireland is under consideration to increase the dose of anti‐D immunoglobulin given following delivery from 500 to 1500 U in an attempt to reduce these sensitisations.