[ozmidwifery] Anti-D - new guidelines

[Tom, Tania and Sam Smallwood]

Hi there,   Just received the new guidelines for administration of anti-D to pregnant and post-partum women today in the mail.  To be honest, found it a bit difficult to understand, but maybe I need a bit of extra sleep under my belt before I tackle it again!  My question to the list is this, it appears that due to a shortage of anti-D, the guidelines for administration were changed, and for a period of approx. 2 years, women didn't routinely receive it during their pregnancy.  Now that supplies seem to be more abundant, the guidelines have been changed back, to include administration of one dose of immunoglobulin 624 IU at between 28 and 34 weeks of pregnancy.  So what have the outcomes for the women with negative blood groups during the past 2 years, when this hasn't been routine, and is there adequate research to suggest that every woman should be having this dose?  It is a blood product after all, and a rare and expensive one at that.  I know we all want to err on the side of caution, but it seems strange that it was stopped due to a shortage, and now that it's available, we should all be giving it again, with no explanation of what indeed the impact of not administering it during this antenatal period was.   Hope this makes sense,   Tania