[en] In Belgium, prevention of anti-D immunization is currently based on systematic postnatal prophylaxis associated with targeted antenatal injection in high-risk situations of foeto-maternal haemorrhage.The failures of prevention are mainly due to the non-respect of established guidelines for RhlG prophylaxis, and to spontaneous undetected foetal-maternal haemorrhages without any obvious cause during the third trimester of pregnancy. In order to reduce the rate of residual post-pregnancy anti-D immunization, several countries decided to associate the classical prophylaxis to a routine antenatal anti-D prophylaxis (RAADP) during the 28th or 29th week of gestation. Since a few years, the foetal RHD genotyping in maternal plasma enables us to limit the antenatal prophylaxis only to those D- women carrying a D+ foetus. This paper deals with: the advantages of an antenatal prevention in the light of non-invasive foetal RHD genotyping, the rules rendering prevention protocols efficient whatever the algorithm applied, and the recommended immuno-haematology follow-up of women who received RhlG.
Disciplines :
Hematology Reproductive medicine (gynecology, andrology, obstetrics)
Author, co-author :
Minon, J. M.; Centre Hospitalier Régionale de la Citadelle (Liège) - CHR CITADELLE > Biologie clinique > Immuno-Hématologie
Gerard, Christiane ; Centre Hospitalier Universitaire de Liège - CHU > Hématologie biologique et immuno hématologie
Schaaps, Jean-Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Foidart, Jean-Michel ; Centre Hospitalier Universitaire de Liège - CHU > Gynécologie-Obstétrique CHR
Language :
English
Title :
Rh D foeto-maternal alloimmunization prophylaxis with anti-D immunoglobulins reviewed in the era of foetal RHD genotyping.
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