To access the anti-D immunoglobulin (Ig) administration in pregnancy aide memoire click on the document below.
anti-D-aide-memoire-updated-August-2023.final_
Key points to note
- Women who are confirmed to have immune (allo) anti-D do not need (or should not receive) anti-D Ig
- Where the results of the cell free fetal DNA (cffDNA) screening test are available and show that the fetus/baby is D-negative, anti-D Ig does not need to be given
- Confirm that the cffDNA result relates to the current pregnancy
- Person administering anti-D Ig should confirm the woman’s identity, discuss risk/benefits, gain informed consent and record in patient’s notes. Confirm product dose and expiry date
- Following potentially sensitising events (PSE- see appendix 1), anti-D Ig should be administered as soon as possible and always within 72 hours of the event. If, exceptionally, this
deadline has not been met some protection may be offered if anti-D Ig is given up to 10 days after the sensitising event - Each new sensitising event should be managed with a dose of anti-D Ig independent of previous or subsequent planned doses (including RAADP)
- In the event of continual uterine bleeding which is clinically judged to represent the same sensitising event, with no features suggestive of a new presentation or a significant change
in pattern or severity of bleeding, a minimum dose of 500 IU anti-D Ig should be given at 6 weekly intervals. Feto-maternal haemorrhage (FMH) screening should be performed
every 2 weeks from 20 weeks onwards - Appropriate tests for FMH should be carried out for all D-negative, pregnant women who have had a PSE after 20 weeks of gestation and additional dose(s) of anti-D Ig should be
administered as indicated. Tests for FMH are also indicated if cell salvage has been used as top up doses (>1500 IU recommended) may be needed - Routine Antenatal Anti-D Ig Prophylaxis (RAADP) is a separate entity for unidentified events through to delivery, and should always be given at the appropriate time in the second
trimester, even if the woman has already received one or more doses of anti-D Ig for PSE - A minimum dose of 1500 IU should be given where autologous cell salvage products have been reinfused