title: Appropriate provision of anti-D prophylaxis to RhD negative pregnant women: a scoping review.
abstract: BACKGROUND
  The purpose of this scoping review was to review the literature on healthcare provider provision of anti-D prophylaxis to RhD negative pregnant women in appropriate clinical situations in various healthcare settings.
  
  
  METHODS
  A scoping review framework was used to structure the process. The following databases were searched: CINAHL (EBSCO), EBM Reviews (OvidSP), Embase (OvidSP), Medline (OvidSP), and Web of Science (ISI). In addition, hand searching of article references was conducted. The search yielded 301 articles. Thirty-five articles remained for review after screening. Two team members reviewed each article using a detailed data collection sheet. A third reviewer was utilized if discrepancies occurred amongst reviewers.
  
  
  RESULTS
  The review process yielded 18 included articles. The majority of the studies were conducted in the United Kingdom. Of the 18 studies, 15 were retrospective studies. The articles were largely conducted in one institution. The articles with a focus on routine antenatal provision of anti-D immunoglobulin found that it was given 80 to 90% of the time. Postpartum provision of anti-D immunoglobulin had significantly higher results of 95-100%. The review found that the delivery of anti-D immunoglobulin to RhD negative pregnant women during situations of potential sensitizing events was suboptimal.
  
  
  CONCLUSIONS
  The included articles examine the management of RhD negative pregnancies in various countries with existing national guidelines. The existing evidence indicates an opportunity for quality improvement in situations where potential sensitizing events are not at routine times in pregnancy, such as miscarriage or fetal demise early in pregnancy. Routine care for the prevention of RhD alloimmunization in pregnancy and postpartum appears to be fairly consistent. The paucity of recent literature in this area leads to a recommendation for further research.
authors.affiliation: Northern Medical Program, University of Northern British Columbia, 3333 University Way, Prince George, BC, V2N 4Z9, Canada. trina.fyfe@unbc.ca.
authors.forename: Trina M
authors.initials: TM
authors.lastname: Fyfe
authors.affiliation: Northern Health - Corporate Office Suite 600, 299 Victoria St., V2L 5B8, Prince George, BC, Canada. jane.ritchey@northernhealth.ca.
authors.forename: M Jane
authors.initials: MJ
authors.lastname: Ritchey
authors.affiliation: Northern Health - Corporate Office Suite 600, 299 Victoria St., V2L 5B8, Prince George, BC, Canada. christonrina.taruc@northernhealth.ca.
authors.forename: Christorina
authors.initials: C
authors.lastname: Taruc
authors.affiliation: Northern Health - Corporate Office Suite 600, 299 Victoria St., V2L 5B8, Prince George, BC, Canada. daniel.crompton@northernhealth.ca.
authors.forename: Daniel
authors.initials: D
authors.lastname: Crompton
authors.affiliation: Northern Health - Corporate Office Suite 600, 299 Victoria St., V2L 5B8, Prince George, BC, Canada. brian.galliford@northernhealth.ca.
authors.forename: Brian
authors.initials: B
authors.lastname: Galliford
authors.affiliation: Northern Health - Corporate Office Suite 600, 299 Victoria St., V2L 5B8, Prince George, BC, Canada. rose04perrin@gmail.com.
authors.forename: Rose
authors.initials: R
authors.lastname: Perrin
mesh_terms: D000022:Abortion, Spontaneous / Q000517:prevention & control; D000743:Anemia, Hemolytic / Q000276:immunology; D005260:Female; D005313:Fetal Death / Q000517:prevention & control; D006801:Humans; D049590:Postpartum Period; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control*; D037841:Pregnant People; D011295:Prenatal Care; D011296:Prenatal Diagnosis; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000517:prevention & control*; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use*; D006113:United Kingdom
chemical_list: D018029:Rho(D) Immune Globulin