Ann Robinson’s research reviews—12 October 2023

Terminating antiDRhesus immunoglobulin (Rho(D), anti-D), has been a game changer for Rh negative pregnant women. Since it’s been routinely given in the third trimester and at delivery, maternal sensitisation rates have fallen from 9-10% at each full term pregnancy to 0.2%. But should we also test and give anti-D after first trimester terminations of pregnancy? New technology that allows detection of low but potentially significant levels of exposure to fetal red blood cells (fRBCs) which might cause maternal sensitisation has provided such much needed clarity.In this prospective US study, 99.8% (505/506) of women who had a first trimester termination of pregnancy (medical or surgical) fell below the threshold for sensitisation in terms of the numbers of fRBCs in their blood after the procedure, and fRBC levels remained unchanged before and after termination of pregnancy. The threshold is a proxy for what we’re trying to prevent—haemolytic disease of the newborn in…
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