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Massive feto‐maternal haemorrhage: effect of passively administered anti‐D in the prevention of Rh sensitization and haemolytic disease of the newborn

Summary. Fourteen mothers carrying ABO compatible but Rh D incompatible pregnancies experienced large feto‐maternal haemorrhages (estimated 188 ml, range 50–400 ml red cells). These were all treated with infusions of fresh frozen plasma containing anti‐D at a mean immunoglobulin to fetal cell ratio of 129 i.u. (25·8 μg)/ml of fetal cells. At 48 h after the infusion 95% of fetal cells had been removed but 3 to 4 days were required for complete removal. The passively administered anti‐D was detectable for up to 6–9 months but not after that time. Four of the 14 women had successful pregnancies subsequently although in two of these anti‐C + D was present. Of these, one resulted in a clinically affected baby who survived exchange transfusion.