Effectiveness of Routine Antenatal Anti-D Prophylaxis in HDFN. v: 1.3

  • Research type

    Research Study

  • Full title

    How effective is the current regimen of routine antenatal anti-D prophylaxis in Haemolytic-Disease-of-the-New-born?

  • IRAS ID

    154080

  • Contact name

    Mohamed Elmi

  • Contact email

    mohamed.elmi@homerton.nhs.uk

  • Sponsor organisation

    Homerton university Hospital

  • Duration of Study in the UK

    4 years, 0 months, 30 days

  • Research summary

    1500 IU prophylactic anti-D is routinely administered to pregnant women who are Rh D negative blood group at 28 weeks of gestation. This prevents the immune system of RhD negative mothers to produce antibodies against their infants, especially when the infant carries different blood group to the mother (RhD positive blood group). \n\nEven though the introduction of prophylactic anti-D has reduced the incidence of Haemolytic Disease of the Foetal and Newborn (HDFN), still 500 foetuses are affected with HDFN every year in England and Wales alone and 25 to 30 of these babies die from HDFN (NICE 2007). \n\nAs a result, this research will investigate into what causes the following issues:\n\nRhD negative mothers who received 1500IU prophylactic Anti-D at 28 weeks and at delivery have no detectable levels of prophylactic Anti-D. This research will investigate if the infants born to these mothers are affected by HDFN. From this, we will also learn if the absence of prophylactic anti-D at delivery means no protection from producing antibodies against their infants. This evidence could influence changing the current regimen in the guideline.\n\nOne single standard dose of anti-D is given to all RhD negative mothers at 28 weeks of gestation, whereas other blood products are issued based on patient’s weight and age.\nThe weight of RhD negative mothers with no detectable levels of Anti-D at delivery will be compared to mothers with detectable levels of Anti-D at delivery\n\nThe level of protection for RhD negative mothers who go above 40 weeks will be investigated since according to the manufacture, Prophylactic Anti-D provides protection for only up to 12 weeks.\n\t\nIf 1500 IU prophylactic anti-D at 28 weeks is sufficient for the full length of RhD negative pregnancy with twin or triple expectations, will also be investigated.\n

  • REC name

    West of Scotland REC 3

  • REC reference

    18/WS/0085

  • Date of REC Opinion

    31 May 2018

  • REC opinion

    Further Information Favourable Opinion