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Evidence summaries

Anti-D Administration after Spontaneous Miscarriage for Preventing Rhesus Alloimmunisation

The data are insufficient of anti-D administration in an unsensitised Rh-negative mother after spontaneous miscarriage. Level of evidence: "D"

Summary

A Cochrane review [Abstract] 1 included 1 study with a total of 48 women who had a miscarriage between 8 to 24 weeks of gestation. Of the 19 women in the treatment group, 14 had therapeutic dilatation & curettage (D&C) and 5 had spontaneous miscarriage; of the 29 women in the control group, 25 had therapeutic D&C and 4 had spontaneous miscarriage. The treatment group received 300 µg anti-D Ig intramuscular injection and were compared with a control group who received 1 cc homogenous gamma globulin placebo. Neihter the primary outcomes (development of a positive Kleihauer Betke test (a test that detects fetal cells in the maternal blood; and development of RhD alloimmunisation in a subsequent pregnancy) nor the secondary outcomes (the need for increased surveillance for suspected fetal blood sampling and fetal transfusions, neonatal morbidity, prematurity, maternal adverse events) were not reported in the included study. The included study did report subsequent Rh-positive pregnancies in 3 women in the treatment group and 6 women in the control group.

Clinical comments

Note

Date of latest search: 28 March 2013

References

  • Karanth L, Jaafar SH, Kanagasabai S et al. Anti-D administration after spontaneous miscarriage for preventing Rhesus alloimmunisation. Cochrane Database Syst Rev 2013;(3):CD009617. [PubMed]

Primary/Secondary Keywords