title: [Guideline for prevention of RhD alloimmunizationin RhD negative women].
abstract: Events following which immunoglobulin (Ig) G anti-D should be given to all RhD negative women with no anti-D alloantibodies: First trimester indications (IgG anti-D sufficient dose of 50 μg*) - termination of pregnancy, spontaneous abortion followed by instrumentation, ectopic pregnancy, chorionic villus sampling, partial molar pregnancy; Second and third trimester indications (IgG anti-D sufficient dose of 100 μg*) - amniocentesis, cordocentesis, other invasive prenatal diagnostic or therapeutic procedures, spontaneous or induced abortion, intrauterine fetal death, attempt at external cephalic version of a breech presentation, abdominal trauma, obstetric hemorrhage; Antenatal prophylaxis at 28th weeks of gestation (IgG anti-D sufficient dose of 250 μg*); Delivery of an RhD positive infant** (IgG anti-D sufficient dose of 100 μg*); Minimal dose*: before 20 weeks gestation - 50 μg (250 IU), after 20 weeks gestation*** - 100 μg (500 IU); Timing: as soon as possible, but no later than 72 hours after the event. In cases where prevention of RhD alloimmunization is not performed within 72 hours of a potentially sensitising event, it is still reasonable to administer IgG anti-D within 13 days, and in special cases, administration is still recommended up to a maximum interval of 28 days postpartum; Legend: *administration of a higher dose of IgG anti-D is not a mistake, ** also if the D type is not known, *** simultaneous assessment of the volume of fetomaternal hemorrhage (FMH) to specify the dose is suitable; The FMH volume assessment - If the volume of fetal erythrocytes (red bood cells, RBCs) which entered maternal circulation is assessed, intramuscular administration of IgG anti-D in a dose of 10 μg per 0.5 mL of fetal RBCs or 1 mL of whole fetal blood is indicated. IgG anti-D in a dose of 10 μg administered intramuscularly should cover 0.5 mL of fetal RhD positive RBCs or 1mL of whole fetal blood. FMH is the fetal RBC volume; fetal blood volume is double (expected fetal hematocrit is 50%).
authors.affiliation: Porodnicko-gynekologická Klinika LF UP a FN, Olomouc, Prednosta prof. MUDr. R. Pilka, PhD. marek@lubusky.com
authors.forename: M
authors.initials: M
authors.lastname: Lubušký
authors.forename: M
authors.initials: M
authors.lastname: Procházka
authors.forename: O
authors.initials: O
authors.lastname: Simetka
authors.forename: I
authors.initials: I
authors.lastname: Holusková
mesh_terms: D005260:Female; D005331:Fetomaternal Transfusion / Q000276:immunology; D006801:Humans; D007518:Isoantibodies / Q000276:immunology; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000517:prevention & control*; D012203:Rh Isoimmunization / Q000517:prevention & control*; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use*
chemical_list: D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin