Anti‐D administration after childbirth for preventing Rhesus alloimmunisation

摘要: Background The development of Rh immunisation and its prophylactic use since the 1970s has meant that severe Rhesus D (RhD) alloimmunisation is now rarely seen. Objectives objective this systematic review was to assess effects giving anti-D negative women, with no antibodies, who had given birth a positive infant. Search strategy We searched Cochrane Pregnancy Childbirth Group trials register, Controlled Trials Register, MEDLINE (from 1966 January 1999) reference lists relevant articles. Date last search Register: 1999. Selection criteria Randomised in women without antibodies were immunoglobulin postpartum compared treatment or placebo. Data collection analysis Assessments inclusion criteria, trial quality data extraction done by each author independently. Initial analyses included all trials. Other assessed effect quality, ABO compatibility dose. Main results Six eligible prophylaxis involved over 10,000 but varied. Anti-D lowered incidence RhD six months after (relative risk 0.04, 95% confidence interval 0.02 0.06), subsequent pregnancy 0.12, 0. 07 0.23). These benefits seen regardless status mother baby when within 72 hours birth. Higher doses (up 200 micro grams) more effective than lower 50 preventing pregnancy. Reviewer's conclusions Anti-D, childbirth, reduces have However evidence on optimal dose limited.