Anti D Immunoglobulin

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14B. IMMUNOGLOBULINS in 14. IMMUNOLOGY & ALLERGY
ANTI D IMMUNOGLOBULIN
IMMUNOGLOBULIN

Indications & Dose: ANTENATAL PROPHYLAXIS IM Adult 2 doses of at least 500units given at 28 & 34 wks gestation (postnatal prophylaxis is still necessary) | FOLLOWING ANY POTENTIALLY SENSITIZING EPISODE IM Adult Up to 20 wks gestation, 250 µg/episode (after 20 wks, 500 µg) immediately/within 72h (if longer period has elapsed, it may still give protection & should be used)Ex: abortion, miscarriage, still-birth, amniocentesis | FOLLOWING Rh (D) INCOMPATIBLE BLOOD TRANSFUSION IM Adult 10–20 µg/ml transfused Rh +ve blood | ITP IV Adult Initially 250units/kg (50µg/kg) in 2 divided doses on separate days if desired; MD: 125-300units/kg (25-60µg/kg) based on response [reduced initial dose of 125-200units/kg (25-40 µg/kg) in patients with pre-existing anaemia (Hg <10 g/dL)] | POSTNATAL PROPHYLAXIS IM Adult 500units (100µg) inj will clear up to 4mL of fetal red cells, additional dose depends on amount of transplacental bleeding (additional 125units for each mL of red cells require if bleeds exceeding 4 mL)Given to Rh –ve mothers with no anti-D antibodies in their serum & who have just delivered Rh +ve infants | RISK OF TRANSPLACENTAL HEMORRHAGE IM Adult 250units at up to 20 wks gestation & 500units after 20 wks gestationAny Rh -ve woman at risk of transplacental haemorrhage during pregnancy & not known to be sensitised

Contra: Treatment of ITP in Rh -ve or splenectomised patients, Rh +ve individuals(during prophylaxis of rhesus sensitisation)

Precautions: IgA deficiencies, renal impairment, blood transfusion in patients with ITP

ADR: Serious: hypersensitivity reactions, facial flushing, acute renal insufficiency, disseminated intravascular coagulation, hemolysis, Others: local reactions with pain & tenderness, back pain, discoloured urine, anemia, nausea, headache, fever, chills

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