Rh D alloimmunization can be prevented with the administration of anti-D immune globulin. ACOG recommends administration of anti-D immune globulin to unsensitized Rh D-negative women as follows
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All pregnant women are currently tested at the time of the first prenatal visit for ABO blood group and Rh D type and screening for red cell antibodies. The potential volume of fetal–maternal hemorrhage that can cause Rh D alloimmunization is extremely variable and ranges from 0.1 mL to 30 mL. Data is limited when it comes to many of the potential sensitizing events and therefore some of the recommendations are based on consensus and expert opinion.
Clinicians are advised to administer Rh D immune globulin to patients with weak D blood type in appropriate clinical situations, by the same rationale as that for Rh D typing blood donors, until further scientific and economic studies are available.
Previous administration of human anti-Rho(D) immune globulin (RhoGam) does not generally interfere with an immune response to rubella vaccine and is not a contraindication to postpartum vaccination. However, women who have received anti-Rho immune globulin should be serologically tested 6–8 weeks after vaccination to ensure that seroconversion has occurred.
ACOG Practice Bulletin 181: Prevention of Rh D Alloimmunization
ACOG Practice Bulletin 192: Management of Alloimmunization During Pregnancy
CDC: Epidemiology and Prevention of Vaccine-Preventable Diseases – Rubella
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