Prevención de la isoinmunización materna al RhD, con γ-globulina anti-D

Abstract

Objective. To report our experience in preventing RhD maternal isoimmunization by using anti-D gamma globulin among Rh-negative women. Material and methods. Between 1982 and 1995, immunologic and hematologic data were collected from all Rh-negative women seen at Mexico's National Perinatology Institute. Women at risk of Rh isoimmunization were given a prophylactic dose of 150 μg of anti-D gamma globulin. Results. A total of 4 857 Rh-negative women were seen during the study period (4.85% of the total population of women seen at the Institute), 629 (13.0%) of whom developed RhD isoimmunization; 542 (86.2%) of these women were already isoimmunized when first seen at our Institute. Twenty-two women (3.5%) developed isoimmunization even after receiving a proper dose of anti-D gamma globulin. Prophylaxis was given to 2 605 women (53.6%); 2 039 received a single dose, and 475 two doses. Prophylaxis failed in 22 cases; four were women with multiple pregnancy and 18 developed obstetric pathologic conditions. Conclusions. The use of anti-D gamma globulin resulted in a reduction of maternal Rh isoimmunization to less than one case per 1 000 women. Failures to prevent isoimmunization were associated to additional obstetric conditions and to lack of adherence to prevention guidelines.