579 INTRAUTERINE OR INTRAPARTUM Rh ISO-SENSITIZATION AND USE OF MICRhoGAM IN THE NEONATE

Abstract

To investigate incidence and timing of a possible transfusion of Rho (D)-positive (Rh+) maternal cells to a fetus with Rho (D)-negative (Rh-) cells and the role of Rho (D) immune globulin in prevention of potential primary sensitization, 354 Rh-infants born to Rh+ mothers were studied. MICRhoGAM (MRG) (50ug) was administered to 114 female infants in the first 72h. of life and 240 infants were controls (52 females, 188 males). Of 263 cord serums screened, antibody was found in 6, none of which were anti-D on retesting against a 10 red-cell panel. Two of 167 heel stick samples obtained from infants at 2 days of age revealed maternal Rh+ cells (courtesy B.Clauss & E.R. Jennings). No anti-D antibody was found in either infant at 3 and 6 mo. of age. No anti-D was found in 207 serum samples from control infants (158 males, 49 females) who were ½ to 17 mo. of age; however, 26 of 94 MRG recipients had anti-D between 2½ and 5 mo. of age. (RhoGam may be detected up to 6 mo.) Reports indicating significant risk for either intrauterine or parturition primary anti-D sensitization cannot be corroborated by our studies. Primary sensitization not presently detectable may be confirmed later by an amnestic anti-D response on a second exposure to Rh+ cells, perhaps during pregnancy with a Rh+ fetus. Long term follow-up will ultimately decide the immunoprophylactic role of MRG in prevention of Rho (D) iso-sensitization.

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