Anti-D Update and New Rhesus Screening.

In Australia around 1 in 7 people have a Rhesus D (RhD) negative blood group. In pregnancy, if your blood group is RhD negative and you have an RhD positive fetus, there is a risk of the crossing over, or leaking, of fetal red blood cell RhD antigens. If you have any bleeding in pregnancy, this then causes an immune response. 

There is then a risk that future pregnancies can be affected by a condition called Haemolytic Disease of the Fetus and Newborn, which can cause stillbirth and neonatal jaundice. 

The use of an injection of an antibody called Anti-D would prevent the maternal reaction to the leaked fetal cells in a mother’s circulation. 

Since 1966 in Australia we have been using Anti-D injections in maternity care for all RhD negative mothers who have partners with a confirmed RhD positive blood group. RhD negative women receive Anti-D if vaginal bleeding occurs in pregnancy as well as prophylaxic doses given at 28, 34 weeks gestation and after birth. Anti D is also used in other medical procedures in maternity care for a Rh D negative women. 

Community members can donate their blood plasma, and one man we have celebrated over the years in Australia is James Harrison, who donated his plasma 1,173 times over 50 years as he had Anti-D rich blood following lifesaving surgery and blood transfusions when he was 14 years old. 

Sadly James passed away earlier this year, and he has been celebrated and honoured after such generosity and grace over his lifetime. He retired from donating at the blood bank when he turned 81. 

Fetal Rhesus Screening.

With latest technology, it is now possible to determine the fetal Rhesus status by a new genetic test known as the Fetal Rhesus Screening, which can be done from 11 weeks gestation. 

By taking a sample of a mother’s blood, the test can detect the RhD gene sequence found in maternal blood plasma. The absence of the RhD gene, will then indicate that the Anti-D injections will not be required. Repeat testing is recommended around 28 weeks gestation for confirmation. 

It is predicated that 40% of the current Anti-D injections will not be required due to this genetic testing. Testing would be recommended for each pregnancy as fetal blood group can differ. 

The need for this new testing or Anti-D will be discussed during your early appointments in the rooms with your doctor or our midwife. 

This test is also Medicare covered.