Puerperal sterilization
Keith, L.
Obstetrics and Gynecology 48(5): 632-634
1976
ISSN/ISBN: 0029-7844 PMID: 824588 Document Number: 104835
This letter is in regard to a previous article by Scott and Guy questioning the need for Rh immunoglobulin in patients having puerperal sterilization. Previous recommendations have been based on the assumption that exposure to Rho (D) antigen only put the patient at risk of developing anti-D antibodies. Recently it has been shown that development of antibodies to each blood group is not an independent process but depends on a mechanism set off by Rho(D) antigen. Of 200 Rh-negative women who developed anti-D antibodies, 36% also had other red cell antibodies. Rh-negative isoimmunized patients who had been transfused with Rh-positive blood had a benign clinical course, but they were not protected from other antigens. However, the risk is considered small. In a survey of 5437 facilities, it was found that the risk of Rh incompatible transfusions was greatest among facilities performing the fewest transfusions. Rh negative blood has not always been available. Anti-Rh prophylaxis has prevented formation of antibodies after incompatible transufsions.