The effectiveness of the organization and specific prevention of Rh-conflict during pregnancy

Abstract

AIM: The aim of the study was to evaluate the effectiveness of the organization and medical provision of complex specific antenatal and postpartum prevention of primary isoimmunization with domestic anti-Rh0(D) immunoglobulin in Rh-negative women. MATERIALS AND METHODS: To achieve the goal, an algorithm for managing pregnancy in Rh-negative women was developed, complex antenatal and postpartum prophylaxis of primary isoimmunization with anti-Rh0(D) immunoglobulin was carried out, and its effectiveness was evaluated in 37 women who gave birth to Rh-positive newborns. If antibodies to the Rh0(D) antigen were not detected, then at 28 weeks pregnant women were administered human immunoglobulin anti-Rh0(D) at a dose of 1500 IU (300 g). Anti-Rh0(D) antibody titer was monitored every 23 weeks before delivery. Mothers were re-introduced with human anti-Rh0(D) immunoglobulin at a dose of 1500 IU (300 g) within 2472 hours after the birth of an Rh-positive child. 6 months after delivery, the antibody titer to the Rh0(D) antigen was re-determined. RESULTS: After the introduction of domestic human immunoglobulin anti-Rh0(D), side effects and allergic reactions were not registered. All 37 (100%) women were delivered at term, of which 7 (18.9%) were delivered abdominally. All newborns were born with an Apgar score of 89 without hemolytic disease. The titer of antibodies to the Rh0(D) antigen was negative in 24 (64.9%) women 6 months after delivery. 13 (35.1%) mothers had a post-vaccination antibody titer not higher than 1 : 2, which is allowed by the instructions for the anti-Rh0(D) human immunoglobulin preparation. They tested negative again 12 months after delivery. CONCLUSION: The results of the study showed a rather high efficiency of the organization and medical provision of complex specific antenatal and postpartum prevention of primary isoimmunization with domestic anti-Rh0(D) immunoglobulin in Rh-negative women.