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Editor, – Further to my article on the shortage of Rhesus D immunoglobulin (Aust Prescr 2000;23:36-8), a mini-dose of Rh D was marketed in May 2001. This has the dosage of 250 IU and should be offered to every Rh D negative woman with no preformed anti-D antibodies, for problems in the first twelve weeks of gestation. The indications usually include miscarriage, termination of pregnancy, ectopic pregnancy and chorionic villous sampling. The 250 IU dose is sufficient to prevent immunisation by a fetomaternal haemorrhage of 2.5 mL of red blood cells (5 mL of whole blood).
The introduction of the mini-dose is a significant achievement as currently a larger than necessary dose is being used for these first trimester indications. This will therefore allow a more efficient usage of the limited amount of anti-D.
A communication plan is being developed.
Mark Dean
Assistant Director
Australian Red Cross Blood Service - NSW
Sydney
