[Results of postpartum Rhesus prophylaxis 1967 to 1990].
BACKGROUND
The aim of the study is to analyse the benefit of rh-prophylaxis at the Universitäts-Frauenklinik Köln from 1967 to 1990.


METHODS
During that period 28,761 births, of whom 2602 were non-sensitized rh-negative mothers with a rh-positive child (9.04%), were assessed. 2223 mothers received rh-prophylaxis, in 379 cases rh-prophylaxis was omitted particularly within the first 4 years of the study period, due to a limited provision of anti-D immunoglobulines. From 1972 onwards postnatal rh-prophylaxis was omitted in only 3%. In 14.5% of the 379 women without rh-prophylaxis contamination of the maternal circulation system with HbF cells was confirmed by the Kleihauer-Betke-Test. In 98.4% of the cases rh-prophylaxis was performed postnatally within the first 72 hours.


RESULTS
During the study period the initial dosage of IgG anti-D was set at 55 - 150 microgram i.v. (n = 217) and later increased to 150 - 250 microgram i.v. (n = 1109) and finally to 300 - 330 microgram i.m. (n = 897). After rh-prophylaxis presence of HbF cells in the maternal circulation was found in 5.5% of the mothers of group 1, in 2.1% of the second group and in 1.1% of the third group. In the group of mothers without rh-prophylaxis 69 had a second delivery and rh-sensitsation was found in 7.3% of these cases. Of 537 women having received rh-prophylaxis who delivered a second rh-positive child, 9 (1.7%) showed rh-sensitisation. of the 352 women with rh-incompatibility 8 (2.3%) had already been sentisized during their first pregnancy.


CONCLUSIONS
The study confirms that postnatal application of anti-D immunoglobulins is effective to a great extent but does however not completely exclude rh-sensitisation. Furthermore, we recommend the additional prenatal rh-prophylaxis as introduced by the German maternity regulations since 1990.
Schlensker
K H
KH
Universitäts-Frauenklinik Köln.
Krüger
A A
AA
D000328:Adult; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004899:Erythroblastosis, Fetal / Q000453:epidemiology / Q000276:immunology / Q000517:prevention & control*; D005260:Female; D005319:Fetal Hemoglobin / Q000032:analysis; D005500:Follow-Up Studies; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000627:therapeutic use*; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D018029:Rho(D) Immune Globulin; D016896:Treatment Outcome
D007518:Isoantibodies; C061961:RHO(D) antibody; D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin; D005319:Fetal Hemoglobin