PREVENTION OF RHESUS IMMUNIZATION DURING A POTENTIALLY SENSITIZING EVENT

The paper presents experience in following up and managing rhesus-negative pregnant women having a gestational complication as threatened miscarriage with vaginal bleeding (a potentially sensitizing event (PSE)). It notes the importance of preventive measures as a component of management tactics and the necessity of preventing the development of immunization in unsensitized patients. Objective. To assess the risk for rhesus immunization in rhesus-negative pregnant women with threatened miscarriage when preventing and not preventing PSE. Subjects and methods. The investigation included 56 rhesus-negative pregnant women aged 27-35years without antibody titers with the above-mentioned gestational complication. A study group consisted of 29pregnant women with threatened miscarriage accompanied by vaginal bleeding, who underwent prenatal ad hoc prevention of rhesus immunization with human immunoglobulin anti-rhesus Rho(D). A comparison group comprised 27 pregnant women with threatened miscarriage accompanied by vaginal bleeding, who had not prenatal ad hoc prevention of rhesus immunization because of their refusal. Results. The immunized pregnant women who had not received a prophylactic immunoglobulin dose for gestational complications were 7.4% (n=2); and those who had not used this dose for gestational complications and refused prenatal prophylaxis at 28-30 weeks’ gestation were 11.1%. Conclusion. Ad hoc prevention of Rh immunization in this cohort of patients in conjunction with decreed antenatal and postnatal prophylaxis prevents the development of maternal immunization to Rh-1) antigen.

rhesus immunization, prevention, threatened miscarriage