WHY ADMINISTER AN ANTI-D INJECTION DURING PREGNANCY?
Dr. Claude ALLOUCHE, obstetrician-gynecologist
Ahuza Clinic, Raanana, Israel, 058 726 02 64
Anti-D administered during pregnancy at 28 weeks reduces the incidence of antibody formation and probably reduces Rh alloimmunization in women as well.
Women with Rh-negative blood can produce anti-Rh antibodies when carrying a Rh-positive baby, in response to different erythrocyte antigens from the baby.
This sensitization is more likely to occur during delivery, but sometimes occurs during pregnancy in case of bleeding and sometimes at the end of pregnancy without any symptoms.
Indeed, in certain situations, fetal blood can pass into the maternal blood in small quantities and generate the production of anti-Rh antibodies in the mother's body, which will remember them and quickly produce them again upon new exposure to a Rh-positive fetus in a subsequent pregnancy.
These antibodies can cause anemia, and sometimes death, for a Rh-positive baby in a subsequent pregnancy.
This is why it is recommended to perform an anti-D serum injection during pregnancy:
in case of bleeding from the 1st trimester
in case of direct impact on the belly
systematically between 28 and 34 weeks
after delivery when the baby's blood group is Rh-positive
This anti-D serum injection will neutralize fetal cells from a Rh-positive baby that would have passed into the maternal blood before the mother has time to produce them herself and remember them.
It must take place within 72 hours following bleeding or trauma, or between 28 and 34 weeks if done systematically.
Usually, when the patient is hospitalized, the hospital administers the injection. Otherwise, the patient is asked to turn to her koupat holim to have it done within 72 hours.
Recently, in some countries like France (but not in Israel), it is possible to determine the baby's blood group by analyzing fetal cells floating in the maternal blood through a simple blood test on the mother. This way, the anti-D serum injection can be performed only for patients with a Rh-positive baby.
After birth, it is easier to determine the baby's blood group through a simple blood test. If it is Rh-positive, the mother will receive an additional injection of anti-D antibodies within 72 hours following birth. If the baby's blood group is Rh-negative, this injection is unnecessary.
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