Current Guidelines on Anti-D Prophylaxis –Are they Effective, can they be Improved?
(3) The panel is concerned that there is abundant evidence that the guidelines are not being fully applied. (4) The generally accepted UK guidelines are Recommendations For The Use Of Anti-D Immunoglobulin (National Blood Transfusion Service Immunoglobulin Working Party, 1991). The panel recommends that these should at present remain the reference standard for good clinical practice and that there shouls be no change to the dosage principle of 500 IU for 4 ml of fetal red blood cells. We are reassured to learn that there is an expert group currently undertaking review and revision of the current guidelines, with particular attention being given to the use of anti-D IgG in the first trimester of pregnancy. Failures of compliance are particularly common following potentially sensitising events during pregnancy, both in respect of the administration of anti-D IgG and the estimation of size of feto-maternal haemorrhage (FMH) by Kleihauer, or alternative, tests. (5) Awareness of the need fo
