Anti D Injection in Pregnancy

Anti D Injection in Pregnancy

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Approximately 85% of the Australian population have a Rhesus (Rh-D) positive blood group and 15% a (Rh-D) negative group.

Like all blood groups the Rh factors is inherited. If an Rh-D negative woman falls pregnant to an Rh-D positive man there is a 1 in 4 chance that the baby will be Rh-D positive.

During the pregnancy and birthing process, there is a risk that some of the baby’s blood cells will get into the mother’s blood stream and she will form antibodies (Isoimmunisation) against the baby’s blood. If a mother who has developed the antibodies has another Rh positive baby, her antibodies will cross the placenta and may damage the baby’s red blood cells. Untreated babies may be anaemic, have a risk of brain damage or even die before birth. Doctors call all of these problems ‘haemolytic disease of the newborn’ or ‘HDN’.

 Anti D injection in pregnancy

The use of ‘anti-D’ has greatly reduced the incidence of HDN by reducing the chances of a woman forming antibodies from about 1.5% to 0.2%.

If the mother is given an injection of Anti-D within 72 hours of delivery, miscarriage or amniocentesis then the baby’s cells which have entered the bloodstream may be neutralised and thus harmful antibodies will not be produced.

It is routine practice therefore to offer all Rh-D negative mothers Anti-D immunoglobulin injection during pregnancy (2 doses, at 28 and 34 weeks gestation), after delivery (if the baby is Rh-D positive).

You may need to have the injection earlier if you:

  • Have any vaginal bleeding during your pregnancy
  • Have a miscarriage
  • Have an abortion or terminate your pregnancy
  • Have a medical procedure such as an amniocentesis

In some cases a blood sample may be taken prior to receiving Anti-D

Anti-D is given as an injection, usually into a muscle in your arm or leg. For some people with bleeding problems, the injection may need to be given under the skin (subcutaneously).

You may feel tender or stiff where the injection was given. This will pass in a few hours
Occasionally a temperature or hives may occur but these are very rare and are easily treated.

There is no evidence that being given an Anti-D injection while you are pregnant will harm your baby. If, however, you decide against this, you will still be offered the injection after the birth if your baby is found to be Rh-D positive. You may choose not to have the anti-D injection if you are certain that the father of your baby is Rh-D negative.

Men are not tested routinely to find out their blood group, but some people might know their Rh-D status.

You can breastfeed after you have been given an Anti-D injection.

Anti-D is made from blood plasma (the fluid part of the blood). The blood was donated to the Australian Red Cross Blood Service by volunteer donors. To make sure infectious diseases cannot be transmitted by Anti-D injections, every blood donation used to make Anti-D is tested for blood diseases like hepatitis and HIV. To ensure the safety of the blood, the Red Cross also has very strict controls on blood donors. No product made from human blood plasma can be guaranteed 100% free of infectious diseases. However, Anti-D has been used in Australia for more than 30 years, and no one has ever reported being infected from an Anti-D injection.

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