Oral Presentation Australasian Diabetes in Pregnancy Society and Society of Obstetric Medicine Australia and New Zealand Joint Scientific Meeting 2021

Single centre, retrospective review of compliance with routine antenatal Rhesus D prophylaxis (#52)

KATHERINE J CREEPER 1 , Dorothy Graham 1 2 , Simon Kavanagh 3 , Jan Dickinson 2 4
  1. Obstetric Medicine, King Edward Memorial Hospital for Women, Subiaco, WA, Australia
  2. Faculty of Health Sciences and Medicine, The University of Western Australia, Nedlands, WA, Australia
  3. Haematology, PathWest Laboratory Medicine , Subiaco, WA, Australia
  4. Division of Obstetrics and Gynaecology, King Edward Memorial Hospital for Women, Subiaco, WA, Australia

Background

Fetomaternal haemorrhage is the loss of fetal blood cells into the maternal circulation and can cause haemolytic disease of the newborn. Antenatal prophylaxis with Rh(D) immunoglobulin is recommended to minimise Rh(D) alloimmunisation. 

 

Aim

To review compliance with the National Blood Authority and Australian and New Zealand Society of Blood Transfusion guidelines pertaining to the prophylactic use of Rh(D) immunoglobulin and investigation of fetomaternal haemorrhage in obstetric patients.

 

Materials and Methods

A single centre, retrospective cohort study for all Rh(D) negative pregnant women was performed. Maternal demographics, date of delivery, data pertaining to the administration of Rh(D) immunoglobulin and fetomaternal haemorrhage volume were collated and audited against National guidelines. Local research ethics permission was obtained.

 

Results

323 Rh(D) negative women with a mean age of 31 years (SD 5.2 years) and a median gestation at delivery of 39 weeks (IQR 2.6) were identified. 57.6% (n=186) of women had at least one Rh(D) positive infant. Of the 222 women with a complete Rh(D) immunoglobulin administration record, 54.9% (n=122) exceeded the recommended dosage interval of 42 days. No women with a Rh(D) negative infant received Rh(D) immunoglobulin post-delivery.  3 women (1.6%) with Rh(D) positive infants did not receive Rh(D) immunoglobulin post-delivery.

 

Conclusion

A number of women did not receive prophylactic Rh(D) immunoglobulin at the correct time, with a significant number exceeding a dosage interval of 42 days. This could be associated with Rh(D) alloimmunisation and increased risk of haemolytic disease of the newborn in subsequent pregnancies.