PREVENTION OF RH IMMUNIZATION DUE TO LARGE VOLUMES OF RH-POSITIVE BLOOD

Four Rh-negative women who had received large volumes of Rh-positive blood were given incomplete anti-D in an attempt to prevent Rh immunization. Two were cases of transplacental haemorrhage and two received Rh-incompatible transfusions. The patient given 27 ml. of anti-D-containing plasma developed anti-D. The other three patients did not develop anti-D. A mild haemolytic reaction occurred in the patient given anti-D in the form of 370 ml. of blood intravenously. No reactions were seen in the two patients receiving approximately 1,000μg. of anti-D in the form of gammaglobulin intramuscularly. The evidence suggests that Rh immunization by quite large transplacental haemorrhage can be safely prevented by giving anti-D gammaglobulin. A cautious approach to the use of this method in dealing with Rh-incompatible transfusions in women before or during the child-bearing period seems justified. © 1968, British Medical Journal Publishing Group. All rights reserved.