[Anti-d immunoglobulin in pregnancy and immune thrombocytopenia]
Klappenbach R, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A.
Record ID 32018001443
Original Title: Inmunoglobulina anti-D en embarazo y trombocitopenia inmune
Authors' recommendations: CONCLUSIONS High-quality evidence indicates that the use of anti-D immunoglobulin in Rh D-negative women in the immediate puerperium after delivery of an Rh D-positive baby reduces alloimmunization; although the studies do not report results of perinatal morbidity and mortality. Moderate quality evidence on prophylaxis with anti-D immunoglobulin during the third trimester of pregnancy in women Rh D-negative would reduce the incidence of alloimmunization and positive Kleihauser tests; although the evidence on its impact on perinatal outcomes is of very low quality and does not allow to draw conclusions. Low quality evidence on the use of anti-D immunoglobulin for the treatment of newly-diagnosed primary immune thrombocytopenia in Rh D-positive infants and adults did not show improvement in the rate of clinically significant bleedings; although it might mildly increase the platelet count when compared with glucocorticoids and intravenous immunoglobulin. Very low quality evidence does not allow drawing conclusions on the use of this technology for the treatment of secondary immune thrombocytopenias. All the clinical practice guidelines consulted recommend the use of anti-D immunoglobulins in Rh D-negative pregnant women as prophylaxis during the third trimester and during puerperium after delivery of Rh D-positive babies. The clinical practice guidelines on primary immune thrombocytopenia surveyed include anti-D immunoglobulin along with glucocorticoids and intravenous immunoglobulin as treatment options in Rh D-positive children and adults. Argentina’s Mandatory Medical Program (PMO, Programa Médico Obligatorio) as well as most of the coverage policies mention this technology, cover the use of anti-D immunoglobulin in Rh D-negative pregnant women as prophylaxis during the third trimester and during puerperium after delivery of Rh D-positive babies. As regards the treatment for immune thrombocytopenia, only two United States private sponsors cover this technology. No regional economic health assessments on anti-D immunoglobulins have been found.
Project Status: Completed
Year Published: 2018
URL for published report: https://www.iecs.org.ar/home-ets/
English language abstract: An English language summary is available
Publication Type: Not Assigned
- Pregnancy Complications
- Pregnancy Complications, Hematologic
- Purpura, Thrombocytopenic, Idiopathic
- Immunoglobulins, Intravenous
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: firstname.lastname@example.org
Contact Email: email@example.com
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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