Rh‐Prophylaxis with Immunoglobulin Anti‐D Administered during Pregnancy and after Delivery

During 1968-1973 510 Rh-negative, non-Rh-immunized primi- and multigravidae giving birth to Rh-positive infants, regardless of the ABO constellation, received 250 mug immunoglobulin anti-D post partum. In serological follow-ups using the indirect Coombs' test and the papain method more than six months after childbirth, Rh-antibodies were detected in two cases with papain but not at all with the indirect Coombs' test. Seventy women gave birth to Rh-positive babies in subsequent pregnancies. Twenty-six of these non-Rh-immunized women were given an intramuscular injection of 250 mug anti-D five to ten weeks before delivery and were included in a series comprising a total of 131 Rh-negative women who had received immunoglobulin anti-D in the estimated 32nd-34th week of pregnancy. Bilirubin and haemoglobin were determined in the neonates on cord blood and serum. The infants whose mothers had received immunoglobulin anti-D during pregnancy showed no signs of haematological abnormalities related to the administration of immunoglobulin anti-D. The determination of cord blood haemoglobin or bilirubin and serum bilirubin revealed no significant difference between Rh-positive infants and Rh-negative ones. Antibodies by the papain method were detected 41 of the women at the time of delivery (22 Rh-positive babies and 19 Rh-negative ones). There was no correlation between the time at which immunoglobulin anti-D was administered and the detection of antibodies at the time of delivery, regardless of the Rh group of the infant. The indirect Coombs' test was positive only in ten of the 48 Rh-negative infants examined. 250 mug immunoglobulin anti-D provides effective post partum prophylaxis, and the same dose administered to Rh-negative pregnant women prior to delivery did not cause any detectable haemolytic damage to the fetus.