Anti-D following Early Pregnancy Loss
Anti-D Following Early Pregnancy Loss
Patient Information
Obstetric Service
- Author ID: JD
- Leaflet Ref: Gyn 042
- Version: 7
- Leaflet title: Anti-D following Early Pregnancy Loss
- Date Produced: July 2024
- Expiry Date: July 2026
Why have I been offered an Anti D injection?
Your blood group is Rhesus negative. If you have unfortunately suffered a pregnancy loss which required surgical treatment you will be given an injection of Anti D as part of your care. If Anti D is not given to Rhesus negative ladies who lose an early pregnancy, they may become sensitised to Rhesus positive blood. If this occurs there may be complications in the next pregnancy, so it is important to try and prevent this.
What does it mean being Rhesus negative?
People can belong to one of four blood groups, A, B, AB and O. There is another important difference in people’s blood called Rhesus factor, which is also found on the red blood cells. People who are Rhesus positive have a substance known as D antigen on the surface of their red blood cells – they are said to be Rhesus positive. People who are Rhesus negative do not have the D antigen on their blood cells – they are Rhesus negative. Blood groups and Rhesus factors are inherited from your parents. In Europe around 85% of people are Rhesus positive and 15% are Rhesus negative.
If red cells from the foetus are Rhesus positive and cross the placenta into the blood stream of a Rhesus negative woman they can stimulate an antibody response. This can happen during a routine pregnancy, miscarriage and trauma to the uterus (e.g. a car accident) during pregnancy.
The antibody response will produce a blood substance (antibody) that will cross the placenta and cause a breakdown of the red cells of a Rhesus positive baby causing Haemolytic Disease of the Newborn (HDN). HDN ranges from jaundice, to in severe cases, death of the baby.
The injection of Anti-D is given to reduce the likelihood of the antibody response and HDN in future pregnancies.
What is Anti-D?
Anti-D is a drug called an immunoglobulin. It is produced from plasma (the fluid part of blood) from blood donors. It is an injection given into a muscle in the arm. Rhophylac is a brand of Anti D.
Is Anti-D safe?
While it is a blood product, there have been no known cases of viral transmission (transmission of viruses like hepatitis and HIV) using Anti-D.
Are there any side effects to Anti-D?
Side effects are rare. You may experience some redness or soreness at the site of the injection.
What should I do in my next pregnancy?
In the future if you become pregnant and are Rhesus negative, your midwife, obstetrician or GP should discuss Anti-D treatment with you and explain the options available so that you are fully informed.
A nurse, midwife or doctor will be happy to tell you more about the Rhesus factor and what it means to you.
Reference
Recommended by the National Institute for Clinical Excellence; Routine antenatal Anti-D prophylaxis for women who are Rhesus negative. Technology Appraisal Guidance TA156, August 2008
Ectopic pregnancy and miscarriage: diagnosis and initial management
NICE guideline [NG126] Published: 17 April 2019 Last updated: 23 August 2023