Controversies in Rh prophylaxis

Who needs Rh immune globulin and when should it be given?
  • John M. Bowman
    Reprint requests: John M. Bowman, M.D., Rh Laboratory, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
    Rh Laboratory, Department of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada

    the Health Sciences Centre, Winnipeg, Manitoba, Canada.
    Search for articles by this author
      This paper is only available as a PDF. To read, Please Download here.


      A summary of the current recommendations for administration of Rh immune globulin after several reproductive events is presented. The risks of failure to administer Rh immune globulin after delivery or abortion, amniocentesis, and massive transplacental hemorrhage are described.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Obstetrics & Gynecology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Nevanlinna HR
        Factors affecting maternal Rh immunization.
        Ann Med Exp Biol. 1953; 31: 1
        • Samson D
        • Mollison PL
        Effect on primary Rh-immunization of delayed administration of anti-Rh.
        Immunology. 1975; 28: 349
        • Bowman JM
        • Chown B
        • Lewis M
        • Pollock JM
        Rh-isoimmunization during pregnancy: antenatal prophylaxis.
        Can Med Assoc J. 1978; 118: 623-627
        • Blajchman M
        • Zipursky A
        • Bartsch FR
        • Hermann M
        • Eklund J
        • Nevanlinna HR
        Rh immunization during pregnancy.
        Vox Sang. 1979; 36: 50-64
        • Tovey LAD
        • Townley A
        • Stevenson BJ
        • Taverner J
        The Yorkshire antenatal anti-D immunoglobulin trial in primigravidae.
        Lancet. 1983; 2: 244-246
        • Bowman JM
        • Pollock JM
        Antenatal Rh prophylaxis: 28 weeks' gestation service program.
        Can Med Assoc J. 1978; 118: 627-630
        • Mollison PL
        Can primary Rh immunization be augmented by passively administered antibody?.
        in: Frigoletto Jr, F Jewett JF Konugres AA Rh hemolytic disease—new strategy for eradication. GK Hall, Boston1982: 161-166
        • Nusbacher J
        • Bove JR
        Sounding board. Rh immunoprophylaxis: is antepartum therapy desirable?.
        N Engl J Med. 1980; 303: 935-937
        • Hensleigh PA
        Preventing rhesus isoimmunization. Antepartum Rh immune globulin prophylaxis versus a sensitive test for risk identification.
        Am J Obstet Gynecol. 1983; 146: 749-755
        • Cohen F
        • Zuelzer WW
        The transplacental passage of maternal erythrocytes into the fetus.
        Am J Obstet Gynecol. 1965; 93: 566
        • Bernard B
        • Presley M
        • Caudillo G
        • et al.
        Maternal fetal hemorrhage: incidence and sensitization [Abstract].
        Pediatr Res. 1977; 11: 467
        • Perrault RA
        • Hogman CF
        Low concentration red cell antibodies. III. “Cold” IgG anti-D in pregnancy: incidence and significance.
        Acta Univ Upps. 1972; 120: 1-16
      1. Bowman JM, Pollack JM. Reversal of Rh alloimmunization—fact or fancy. Vox Sang (in press).

        • Lacey P
        • Caskey CR
        • Werner DJ
        • et al.
        Fatal hemolytic disease of a newborn due to anti-D in an Rh positive Du variant mother.
        Transfusion. 1983; 23: 91