Polyclonal Anti-D Antibodies Significantly Reduce the Rate of
Miscarriages in Rh(D) positive Women with Recurrent Pregnancy loss
Abstract
Objective: Coating of autologous red blood cells (RBCs) with polyclonal
antibodies to Rh(D) antigen may result in an immunomodulation and
improved outcome in Rh(D) positive women with recurrent pregnancy loss
(RPL). Design: Retrospective data analysis. Setting: Rh(D) positive
women with a history of RPL and ineffective treatment with low molecular
weight heparin (LMWH) and/or aspirin Methods: Anti-D (300 µg) was given
subcutaneously to 60 women either prior to pregnancy and/or two times
within 12 weeks of gestation. Main outcome measures: Births of healthy
child/children. Results: Treatment with Anti-D resulted in successful
pregnancies in 67% of all cases. The remaining women had only aborts
(23%) or did not become pregnant (10%). None of the treated women has
developed anaemia due to this treatment or any other significant adverse
reaction. The rate of successful pregnancies does not appear to be
influenced by the administration of: Anti-D prior to pregnancy, age,
thrombophilia or previous alive births. Conclusion: The improved outcome
following the administration of Anti-D in women with RPL might be
explained by immune modulations induced by different immune reactions
including polarization of decidual macrophages. The results obtained in
this study clearly indicate that Anti-D is safe and highly effective in
treatment of Rh(D) positive women with RPL. However, further studies are
required to support our results and to find out the optimal dose and
timing of Anti-D administration. Funding: There was no funding included.
Key words: abort, Anti-D, aspirin, low molecular weight heparin, new
treatment, recurrent pregnancy loss