ANTECEDENTS TO AND OUTCOMES OF RH(D) ISOIMMUNIZATION - MATER-MOTHERS-HOSPITAL, BRISBANE, 1988-1995

We analyzed the antecedents and outcomes of Rh(D) isoimmunization in a local population. Forty-two Rh(D) isoimmunized women attending Mater Mothers Hospital for antenatal care were identified through the Mater Hospital Blood Bank database; their records were reviewed for variable s including sensitizing events, obstetric interventions and pregnancy outcomes. In this group, 74% of women became sensitized despite receiv ing anti-D immune globulin, 17% did not receive anti-D appropriately a nd the others failed to attend for treatment of bleeding in pregnancy. Antenatal sensitization was implicated in 6 women (14%) and potential ly responsible for isoimmunization in another 18. Over half of the 80 viable pregnancies in this study group required some form of obstetric intervention. Thirty pregnancies required amniocentesis and 1 in 3 ba bies underwent either intrauterine or exchange transfusion. Three feta l deaths occurred as a result of severe disease. This study offers inf ormation highlighting circumstances in which immunoprophylaxis guideli nes have failed to impart protection against Rh(D) sensitization and t he consequences of such failures.