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Rho(D) immune globulin or Rh0(D) immune globulin (letter o and digit zero are both widely attested; more at Rh blood group system - Rh nomenclature) is a medicine given by intramuscular injection that is used to prevent the immunological condition known as Rh disease (or hemolytic disease of newborn). It is sold under various brand names. The medicine is a solution of IgG anti-D (anti-RhD) antibodies that take out any fetal RhD-positive erythrocytes which have entered the maternal blood stream from fetal circulation, before the maternal immune system can react to them, thus preventing maternal sensitization.〔Lehne, Richard. Pharmacology for Nursing Care. Saunders and Elsevier, St. Louis. Seventh Edition. p. 819〕 In a Rhesus-negative mother, Rho(D) immune globulin can prevent temporary sensitization of the maternal immune system to Rh D antigens, which can cause rhesus disease in the current or in subsequent pregnancies. With the widespread use of Rho(D) immune globulin, Rh disease of the fetus and newborn has almost disappeared. The risk that a D-negative mother can be alloimmunized by a D-positive fetus can be reduced from approximately 16% to less than 0.1% by the appropriate administration of RhIG.〔Roback et al. AABB Technical Manual, 16th Ed. Bethesda, AABB Press, 2008.〕 Rho(D) immune globulin is composed of IgG antibodies and therefore is able to cross the placenta. In rare cases this can cause a baby to have a weakly positive DAT (direct antiglobulin test) due to sensitization of fetal cells from mothers who have received multiple doses of Rho(D) Immune Globulin. However, no treatment is necessary as the clinical course is benign.〔Rudmann, Sally V. 2005. "Textbook of Blood Banking and Transfusion Medicine 2nd Edition." ELSEVIER Saunders. pp 439-441〕 It is on the World Health Organization's List of Essential Medicines, a list of the most important medication needed in a basic health system. ==Medical uses== In a pregnancy where the mother is D-negative and the father is D-positive, there is a 50%-100% chance, depending on whether the father is heterozygous or homozygous for RhD, that the fetus will be D-positive and the mother is therefore at risk for D alloimmunization. These women are candidates for RhIG prophylaxis. The medication has an FDA Pregnancy Category C. It is given by intramuscular injection as part of modern routine antenatal care at about 28 weeks of pregnancy, as recommended by the American College of Obstetricians and Gynecologists (ACOG).〔(【引用サイトリンク】Pregnancy - routine anti-D prophylaxis for RhD-negative women )〕 The '28 weeks' recommendation comes from the fact that 92% of women who develop an anti-D during pregnancy do so at or after 28 weeks gestation.〔Roback et al. AABB Technical Manual, 16th Ed. Bethesda, AABB Press, 2008.〕〔Prevention of Rh D Alloimmunization. ACOG Practice Bulletin Number 4. Washington, DC: American College of Obstetricians and Gynecologists, 1999.〕 RhIG is recommended in the UK after antenatal pathological events that are likely to cause a feto-maternal hemorrhage.〔(【引用サイトリンク】Use of Anti-D Immunoglobulin for Rh Prophylaxis )〕 Applicable 'pathologic events' include accidents which may induce fetomaternal hemorrhage (motor vehicle accidents, falls, abdominal trauma), following obstetric/gynecologic procedures during pregnancy, and at the time of threatened- or spontaneous-/elective abortions, regardless of gestational age. There is not good evidence that the use of Rho(D) immune globulin after a spontaneous miscarriage is needed and a Cochrane review recommends that local practices be followed. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Rho(D) immune globulin」の詳細全文を読む スポンサード リンク
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