Abstract
niocentesis. Miles and Kaback:’ reported possible adverse effects of anti-D immunoglobulin including a higher rate of fetal loss when anti-D immunoglobulin was administered prior to 20 weeks’ gestation. In the present retrospective study, no significant differences were seen in the incidence of pregnant) wastage, intrauterine growth retardation, preterm delivery, mean birth weight, and congenital defects between the group of patients r-eceiving anti-D immunoglobulin and the control group. Since the use of ultrasound prior to amniocentesis and aspiration of clear amniotic fluid are not a guarantee against fetomaternal hemorrhage, we recommend that all Rh-negative women at risk for sensitization undergoing genetic amniocentesis receive 300 pg of anti-D immunoglobulin prophylaxis, regardless of the appearance of the amniotic Huid. If a lesser amount of anti-D immunoglobulin is given, we suggest that a Betke-Kleihauer stain be performed or serum cy-fetoprotein be measured before and after amniocentesis for calculation of the volume of fetomaternal hemorrhage. Then an appropriate neutralizing dose of anti-D immunoglobulin should be administered at the rate of 10 pg for every 1 ml of fetal blood detected in the maternal circulation. Further prospective studies need to be performed to confirm the safety of anti-D immunoglobulin administration in the second trimester of pregnancy.
Published Version
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