Human Anti-D Immunoglobulins

Indications

Pregnancy and Other Obstetrical Conditions in Rh-Negative Women, Unless the Father or Baby are Conclusively Rh Negative:
  • Pregnancy/delivery of an Rh-positive baby irrespective of the ABO groups of the mother and baby
  • Abortion/threatened abortion at any stage of gestation
  • Ectopic pregnancy
  • Antepartum fetal-maternal hemorrhage (suspected or proven) resulting from antepartum hemorrhage (e.g., placenta previa), amniocentesis, chorionic villussampling, percutaneous umbilical blood ... Read more

Pharmacology

Anti-D immunoglobulin prevents a rhesus-negative mother from actively forming antibodies to foetal rhesus-positive RBCs that may pass into the maternal circulation during childbirth, abortion, or certain other sensitising events. It is also used in idiopathic thrombocytopenic purpura to prevent excessive bleeding.

Dosage & Administration

One dose 250 mcg should be given IM immediately or as soon as possible after delivery, or abortion of a Rh-positive child, preferably within 48 hours, but not later than 72 hours post-partum.

Following any potentially sensitizing episode (e.g stillbirth, amniocentesis) up to 20 weeks of gestation 125 mcg per episode (after 20 weeks of gestation, 250 mcg) immediately or within 72 hours.

For antenatal prophylaxis 250 mcg should be given in week 28 & also week 34 of pregnancy. The injection must only be given deep intramuscularly. Do not inject intravenously.

Interaction

Live vaccines should only be admin at least 3 mth after the last dose of immunoglobulin admin.

Contraindications

Splenectomised or rhesus-negative patients, in whom the resultant haemolysis may exacerbate pre-existing anaemia. Hypersensitivity.

Side Effects

Hypersensitivity reactions such as hives, wheezing, urticaria, Pain and tenderness at inj site. Fever, chills, nausea, facial flushing, headache.

Pregnancy & Lactation

Pregnancy Category C. Either studies in animals have revealed adverse effects on the foetus (teratogenic or embryocidal or other) and there are no controlled studies in women or studies in women and animals are not available. Drugs should be given only if the potential benefit justifies the potential risk to the foetus.

Precautions & Warnings

For postpartum usage, it is to be used only for maternal admin. Not for rhesus-positive individuals. Patients should be observed for 20 minutes after admin.

Therapeutic Class

Vaccines, Anti-sera & Immunoglobulin

Storage Conditions

Should be stored in cool and dry place.