Re: [ozmidwifery] Anti-D - new guidelines

[Carole Gilmour]

Tania et al Anti D was never stopped being given during the antenatal period if needed due to possible spillage of fetal blood into the maternal system.  It was never previously given routinely at 28 & 34 weeks.  What is being introduced now that we have extra supplies coming from Canada is prophalactic treatment for all women at 28 & 34 weeks who are RHneg and do not yet have antibodies.  The reason for this is that it has been recognised that in a small percentage of women fetal blood will cross into her circulation without any apparant reason and cause development of antibodies and hence problems for the next child.  The antenatal anti-D is Australian supply and the postpartum dose will be the Canadian supply that is registered for use in Australia.  For several years we used American supply Rhogam which was never registered for use here and at that time all women recieving it were required to sign a consent form.  There is nothing to stop women refusing this 'medication'.  hope this explains a little of the changes Carole ----- Original Message ----- From: Tom, Tania and Sam Smallwood To: [EMAIL PROTECTED] Sent: Friday, December 13, 2002 9:18 PM Subject: [ozmidwifery] Anti-D - new guidelines 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