Rhesus testing and anti‐D prophylaxis in RhD‐negative women undergoing first‐trimester abortion—Systematic Review and Opinion

作者：Kristina Gemzell‐Danielsson, Sharon Cameron, Teresa Bombas, Mirella Parachini, Marek Ľubušký, Aubert Agostini, Sandra Kroeze, Mary Favier, Myriam Chebbah, Alice‐Anaïs Varlet, L.A.W. Verhagen, Christian Fiala · 发表于：International Journal of Gynecology & Obstetrics · 年份：2025 · DOI：10.1002/ijgo.70404 · 被引用次数：2 · 研究领域：Blood groups and transfusion、Prenatal Screening and Diagnostics、Biosimilars and Bioanalytical Methods

BACKGROUND: The introduction of immunoglobulin G (IgG) anti-D prophylaxis for Rhesus D (RhD)-negative women has substantially reduced the incidence of RhD alloimmunization and hemolytic disease of the fetus and newborn in Europe by 85%, transforming fetal health outcomes. However, there is little evidence for the need of giving IgG anti-D prophylaxis to RhD-negative women in first-trimester abortions. OBJECTIVES: To analyze the international and national evidence-based guidelines on Rh testing and anti-D prophylaxis in first-trimester abortion, along with current literature both supporting and opposing this practice, to facilitate informed decision making in clinical practice. SEARCH STRATEGY: A systematic search was conducted in Pubmed/MEDLINE, EMBASE, Cochrane Library, Google Scholar, and Gry literature for publications from January 1, 2003 to January 17, 2024. SELECTION CRITERIA: Guidelines, reviews, meta-analyses, observational and qualitative studies, randomized trials, real-world data, and cohort studies that addressed the use of IgG anti-D prophylaxis in first-trimester abortions were included. DATA COLLECTION AND ANALYSIS: Identified studies were screened and assessed independently by two authors. A standardized extraction grid was used to extract information from the selected articles. MAIN RESULTS: Guidelines published from 2022 onwards, such as those from the World Health Organization, recommend against anti-D for women undergoing first-trimester abortion. In contr...