Rh-prophylaxis in early abortion

Fiala, Christian; Fux, Milena; Danielsson, Kristina Gemzell

doi:10.1080/j.1600-0412.2003.00266.x

Cited by 3 publications

(6 citation statements)

References 10 publications

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“…Ultrasound scanning is not necessary for the provision of medical abortion, nor is routine laboratory testing; however, tests to detect anemia are useful for starting treatment and Rhesus (Rh) blood group typing is helpful where feasible [5].…”

Section: Preabortion Carementioning

confidence: 99%

The combination of mifepristone and misoprostol for the termination of pregnancy

Faúndes

2011

Intl J Gynecology & Obste

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The combination of 200mg of mifepristone followed by 25 μg to 800 μg (depending on gestational age) of misoprostol has been shown to be effective for the termination of pregnancy throughout gestation. The dose of misoprostol should be reduced as gestational age increases. Mifepristone is not indicated for induction of labor with a live fetus because there are no data to confirm that it does not have a possible deleterious fetal effect. The course of treatment and prerequisites for medical abortion and recommended mifepristone and misoprostol regimens for different gestational ages are described, along with the side effects, management of complications, and postabortion care. The use of the mifepristone-misoprostol combination regimen for induction of labor in cases of fetal death is also described.

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Section: Preabortion Carementioning

confidence: 99%

The combination of mifepristone and misoprostol for the termination of pregnancy

Faúndes

2011

Intl J Gynecology & Obste

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“…However, there is no evidence in the literature to show that spontaneous abortion occurring in the first trimester can cause anti-D immunization. 7,9 In this patient, the hightiter, IgG maternal response is unexpected given the 8-week gestation without trauma.…”

Section: Discussionmentioning

confidence: 79%

“…The risk of D immunization in a D-woman is considered to be 1 to 2 percent during a pregnancy with a D+ (ABO compatible) fetus, increasing to 14 to 17 percent during delivery. 7 During normal pregnancy, transplacental hemorrhage (TPH) can occur as early as at 4 weeks after fertilization, or 6 weeks after last menstrual period (LMP). This is the time when fetal and maternal circulations in the placenta have been formed and when the vascularization of the villi and the pumping action of the fetal heart begin.…”

Section: Discussionmentioning

confidence: 99%

Posttransplant maternal anti-D: a case study and review

Senzel

Ahmed²,

Gill³

et al. 2012

Immunohematology

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Plasma from a 35-year-old, D-woman was found to have anti-D, -C, and -G at 5 weeks' gestation and again at 8 weeks' gestation, when she presented with a nonviable intrauterine pregnancy. The anti-D titer increased with a pattern that suggested it was stimulated by the 8-week pregnancy. Six years before this admission, the patient's blood type changed from group O, D+ to group O, D-after a bone marrow transplant for aplastic anemia. Three years after transplant, the antibody screen was negative. After the patient was admitted for the nonviable pregnancy, the products of con-ception were found to be D+ by DNA testing for RHD. There were no documented transfusions or pregnancies during the interval in which anti-D appeared. The timing of the alloimmunization was unusual. In a subsequent pregnancy, fetal D typing was performed by molecular methods.

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“…The earlier arguments in favor of RhIG administration at earlier gestational ages comes from fetomaternal hemorrhage studies [7,8]. But the presence of fetal RBCs in the maternal circulation does not necessarily equate with subsequent sensitization [9,10] and the fact that most fetal cells are in the placenta, it is reasonable to conclude the numbers of fetal cells available to enter maternal circulation in the first trimester are inadequate to cause sensitization. Hollenbach et al also described a cohort of patients receiving a surgical abortion between 6 to 22 weeks.…”

Section: Search Strategymentioning

confidence: 99%

“…The practice of administering RhIG after first trimester abortion is based on expert opinion and is largely extrapolated from data on fetomaternal hemorrhage in late pregnancy. However, the evidence indicates that there is not adequate fetomaternal hemorrhage in first trimester to cause sensitization [9][10][11]27]. Therefore, the recommendation to administer RhIG in the first trimester should depend on resource availability, cost, values, preferences, equity, acceptability and feasibility.…”

Section: Conclusion Implications For Practicementioning

confidence: 99%

Can We Safely Stop Administering Anti-D Immune Globulin to First Trimester Rh-Negative Mothers Undergoing Abortion? A Systematic Review and Meta-Analysis

Belay¹,

H²,

A³

et al. 2021

Annals Gynecol Obstet

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BackgroundThere is no convincing evidence for the benefit of using anti-D immune globulin (RhIG) in the first trimester [1]. The World Health Organization (WHO) recommends that the determination of Rh status and the offer of RhIG prophylaxis are not considered prerequisites for early first trimester (≤ 63 days) medical abortion [2]. According to the North America Abortion Federation (NAF), it is reasonable to forgo Rh testing and RhIG for women having any type of abortion before 8 weeks from the last menstrual period [3].

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Rh-prophylaxis in early abortion

Cited by 3 publications

References 10 publications

The combination of mifepristone and misoprostol for the termination of pregnancy

The combination of mifepristone and misoprostol for the termination of pregnancy

Posttransplant maternal anti-D: a case study and review

Can We Safely Stop Administering Anti-D Immune Globulin to First Trimester Rh-Negative Mothers Undergoing Abortion? A Systematic Review and Meta-Analysis

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