Anti-D human immunoglobulin: new preparation. Important in young Rh D (-) women.

(1) Nat/eaD degrees , a product based on anti-D human immunoglobulin, is marketed in France for the prevention of alloimmunisation to Rhesus D antigen in obstetrics and after mismatched transfusion. (2) Anti-D human immunoglobulin has been in clinical use for more than 30 years. Its assessment is based more on experience than on well-designed comparative trials. (3) A meta-analysis of 6 trials involving more than 10,000 women demonstrated the efficacy of anti-D human immunoglobulin as prophylaxis after delivery of a Rhesus D-positive infant to a Rhesus D-negative woman. However, the optimal dose regimen and route of administration remain unclear. (4) Some data favour the use of anti-D human immunoglobulin after abortion, as it appears to reduce immunisation rates from about 3-4% to 0.4%. (5) Anti-D human immunoglobulin is likely to be effective antenatally in circumstances or procedures carrying a risk of maternal exposure to fetal red cells, although this has not been proved in comparative trials. (6) Efficacy of anti-D human immunoglobulin in anti-D alloimmunisation after mismatched transfusions has been described only in small clinical pharmacology studies in healthy volunteers. (7) The manufacturing process does not rule out a theoretical risk of nude virus or prion transmission, although no cases have been reported with NateaD degrees .