Pregnancy and other obstetrical conditions in Rh-negative women, unless it is confirmed that the father or baby is Rh-negative:

• Pregnancy or delivery of an Rh-positive baby, regardless of the ABO blood group of the mother and baby
• Abortion or threatened abortion at any stage of pregnancy
• Ectopic pregnancy
• Antepartum fetal-maternal hemorrhage (suspected or confirmed) due to conditions such as antepartum bleeding (e.g., placenta previa), amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling, other obstetrical procedures (e.g., external version), or abdominal trauma
• Transfusion of Rh-incompatible blood or blood products

Transfusion: Prevention of Rh immunization in any Rh-negative individual after receiving incompatible Rh-positive blood or blood products such as red blood cells, platelet concentrates, or granulocyte concentrates.

Anti-D immunoglobulin works by preventing a Rh-negative mother from producing antibodies against Rh-positive fetal red blood cells that may enter the maternal circulation during childbirth, abortion, or other sensitizing events. It is also used in the treatment of idiopathic thrombocytopenic purpura to reduce excessive bleeding.

One dose 250 mcg should be given IM immediately or as soon as possible after delivery, or abortion of a Rh-positive child, preferably within 48 hours, but not later than 72 hours post-partum.

Following any potentially sensitizing episode (e.g stillbirth, amniocentesis) up to 20 weeks of gestation 125 mcg per episode (after 20 weeks of gestation, 250 mcg) immediately or within 72 hours.

For antenatal prophylaxis 250 mcg should be given in week 28 & also week 34 of pregnancy. The injection must only be given deep intramuscularly. Do not inject intravenously.

Live vaccines should be administered only after at least 3 months following the last dose of immunoglobulin.

This product is contraindicated in splenectomised patients or rhesus-negative individuals where the resulting haemolysis may worsen existing anaemia. It is also contraindicated in patients with hypersensitivity to the product.

Hypersensitivity reactions such as hives, wheezing, and urticaria may occur. Pain and tenderness at the injection site are common. Other reactions may include fever, chills, nausea, facial flushing, and headache.

Pregnancy Category C. Animal studies have shown adverse effects on the fetus, and there are no adequate controlled studies in humans, or both human and animal studies are lacking. This drug should only be used if the potential benefit justifies the potential risk to the fetus.

For postpartum use, it should be administered only to the mother. It should not be given to rhesus-positive individuals. Patients should be monitored for at least 20 minutes after administration.

Vaccines, Anti-sera & Immunoglobulin

Store in a cool and dry place.