Cost–Benefit Analysis of Indirect Antiglobulin Screening in Rh(D)-Negative Women at 28 Weeks of Gestation

Abbey, Rebecca; Dunsmoor-Su, Rebecca

doi:10.1097/aog.0000000000000224

Cited by 10 publications

(1 citation statement)

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“…Alloimmunization that may occur between GW 24 and GW 28 is of concern, as we do not perform antibody screen beyond GW 24. The seroconversion rate before GW 28 is reported to be low (0.099%) with minimal risk for the fetus during the index pregnancy 21 . Extrapolation to the Norwegian population will mean eight RhD alloimmunizations per year.…”

Section: The Process Of Implementation Of Targeted Raadpmentioning

confidence: 99%

The Norwegian experience with nationwide implementation of fetal RHD genotyping and targeted routine antenatal anti‐D prophylaxis

Sørensen

Bævre

Tomter

et al. 2021

Transfusion Medicine

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Objectives To reduce the risk of RhD alloimmunization during the last trimester of pregnancy, a targeted routine antenatal anti‐D prophylaxis (RAADP) programme was implemented in Norway in 2016. Here, we present and discuss our experience with the nationwide implementation of the programme, and report sample uptake and preliminary data of de novo anti‐D in pregnancy. Background The targeted RAADP was advised by the academic community and evaluated by the health authorities. A National Working Group has conducted the implementation in the transfusion services and contributed to organise the administration of the antenatal anti‐D prophylaxis. Fetal RhD type is determined by non‐invasive prenatal testing at gestational week 24, and anti‐D prophylaxis is administrated at gestational week 28 only to women with RhD positive fetuses. Methods We describe the implementation process of targeted RAADP in Norway. The sample uptake is calculated by comparing the number of fetal RHD screens with the expected number of samples. Results The sample uptake shows regional variations: 88%–100% after 3 years. Promising decrease in de novo anti‐D detected during pregnancy is observed. Conclusions Nationwide targeted RAADP is implemented and included in the Norwegian maternity care programme. Compliance to sample uptake should further improve in some regions. A remaining issue to fulfil is the documentation of the accuracy of the fetal RHD‐typing at all sites. Post‐natal prophylaxis will then be guided by the fetal RHD result. Dedicated registries will ensure data to evaluate the expected reduction in pregnancy‐related RhD immunisations, which is the final success criterion of the programme.

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Section: The Process Of Implementation Of Targeted Raadpmentioning

confidence: 99%