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Anti-D immunoglobulin
Related Subjects: |Antepartum haemorrhage |Postpartum haemorrhage |Acute Haemorrhage |Placenta praevia |Placenta abruption |Anti-D immunoglobulin
💉 About
Anti-D immunoglobulin is used to prevent Rhesus sensitisation in Rh-negative women exposed to Rh-positive fetal red cells. Without it, maternal alloimmunisation may occur, causing haemolytic disease of the newborn (HDN) in future pregnancies. Always ✅ check the BNF link here.
📌 Key Indications
- Postnatal (Rh-positive infant):
- Give 500 IU IM within 72 h of delivery (SC if bleeding disorder).
- If fetomaternal haemorrhage >4 mL → add 100–125 IU per mL of fetal red cells (based on Kleihauer test).
- Potentially sensitising events ≤20 wks:
- Miscarriage, termination, ectopic, CVS, amniocentesis, stillbirth.
- 500 IU within 72 h (SC if bleeding disorder).
- Antenatal prophylaxis:
- Either 1500 IU single dose at 28–30 wks OR two doses of 1000–1650 IU at 28 & 34 wks.
- Incompatible blood transfusion:
- 100–125 IU per mL of Rh-positive red cells transfused.
⚠️ Cautions
- IgA deficiency → risk of anaphylaxis (rare).
- Threatened miscarriage before 12 wks: not routinely required.
- After 12 wks threatened miscarriage: recommended.
📖 References
- BNF: Anti-D immunoglobulin
- RCOG Green-top Guideline No. 22: The Use of Anti-D Immunoglobulin for Rhesus D Prophylaxis
💡 Exam Pearls
- 🩸 Always confirm maternal blood group & antibody screen before administration.
- 💉 Standard route is IM; use SC only if bleeding disorder present.
- 👶 Prevention of HDN is the ultimate aim.
- 📏 Dose depends on timing (antenatal vs postnatal) and haemorrhage volume.
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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