Postpartum Anti-D Immunoglobulin for Rh-Negative Mothers After Rh-Positive Delivery
Anti-D (Rho(D) immune globulin) should be administered to an Rh-negative, nonsensitized mother following delivery of an Rh-positive infant within 72 hours of birth. [1]
Timing After Delivery
- Anti-D should be administered within 72 hours of delivery. [1], [3]
Indications After Birth
Anti-D is indicated when an Rh-negative, nonsensitized mother delivers an Rh-positive infant. [1]
Standard Postpartum Dose
- Anti-D 300 microg (intramuscular or intravenous) is recommended postpartum. [1], [3]
Additional Dosing for Fetomaternal Hemorrhage
- Additional Anti-D should be administered when fetomaternal hemorrhage (FMH) exceeds the dose coverage. [1]
- SOGC guidance specifies additional Anti-D when FMH is greater than 15 mL of fetal red blood cells, based on quantitative FMH testing. [1]
- An alternative dosing approach uses Anti-D 120 microg postpartum with FMH testing to guide additional dosing when FMH exceeds 6 mL of fetal red blood cells. [1]
Common Clinical Constraints
- Routine postpartum testing for FMH is supported by limited evidence because cost-benefit data are insufficient. [1]
When Anti-D Is Not Given Within the Usual Window
- If Anti-D is not administered within 72 hours, Anti-D should be given as soon as possible for up to 28 days after delivery or other potentially sensitizing event. [1]
Product Label–Consistent Timing
- Full-dose Anti-D (1500 IU, equivalent to 300 microg) is labeled for prevention of Rh hemolytic disease by administration to an Rh(D)-negative mother within 72 hours after birth of an Rh(D)-positive infant (when indicated criteria are met). [3]