Prevention of rhesus isoimmunization

Abstract

The prevention of Rh isoimmunization by the giving of anti‐D gammaglobulin to non‐immunized Rh‐negative women after the birth of an Rh‐positive child is discussed under the following headings: Introduction and the ideas leading to the therapy; Clinical trials; Failures and “failures”. Obstetrical factors relevant to immunization; Risks of the prophylaxis, (a) to the mothers, (b) to volunteer blood donors; Dosage of anti‐D gammaglobulin; The Kleihauer test; Priorities in the use of anti‐D, (a) in abortions, (b) in ABO incompatibility between mother and foetus, (c) in hypertensive patients; Provision of anti‐D gammaglobulin; Mechanisms of protection; Leukocyte antibodies and Rh; The role of intensive plasmapheresis to lower anti‐D levels.

Blood Group Incompatibility between Mother and Foetus

“…South Africa. In Johannesburg Shapiro has extensive experience of anti-D plasma and thinks it is preferable to y-globulin; he considers that with suitable precautions the risk of serumtransmitted hepatitis is negligible [M. Shapiro, personal communication, see Clarke (1970) for details].…”

Profilaxis en la Isoinmunizacion Materno-Fetal

“…El empleo de la inmunoglobulina anti Rh* ( D) en el mundo, ha dado lugar a multitud de publicaciones después de las inicialmente hechas por Freda (27), Pollack (28) y otros en 1967; en Australia (7), Canadá (8), República Federal Alemana (9), Países ( 10, 11 ), Suecia ( 12,13), Finlandia (17), Inglaterra (14), Estados Unidos ( 15,16), y en Latinoamérica, en México (18) y Colombia (19). El conjunto de todas esas publicaciones dá fé de su uti I idad y tolerancia .…”

A Hazard of Thyroidectomy [Summary]

“…by Professor C A Clarke MI) FRCP FRS (New Department ofMedicine, University ofLiverpool, Brownlow Hill, Liverpool 3) Reports from all parts of the world where hTmolytic disease of the newborn is a problem continue to show the value of giving anti-D gammaglobulin to previously nonimmunized Rh-negative women after the delivery of an Rh-positive baby (see Clarke 1970).…”