The National Blood Authority (NBA) released the Guidelines on the Prophylactic Use of Rh D Immunoglobulin (Anti-D) in Obstetrics in 2003, with the aim of providing clinical guidance on antenatal prophylaxis. These guidelines also addressed supply constraints at the time of publication by including a staged implementation process for a full antenatal prophylaxis program in Australia.

The NBA met with the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) in October 2016 to discuss options to update Australia’s guidance on the use of Rh D immunoglobulin. The NBA and RANZCOG agreed that a new evidence-based guideline should be developed through a collaborative partnership between the NBA, RANZCOG and other relevant stakeholders.

The development of the guidance is being overseen by a multi-disciplinary Expert Reference Group (ERG) with expertise from a range of clinical settings to ensure they reflect current evidence and best clinical practice.

Expertise on the ERG includes:

  • Obstetricians and Maternal fetal medicine experts
  • Neonatology
  • General Practitioners
  • Haematologists
  • Private pathology
  • Midwives
  • Australian Red Cross Blood Service
  • Consumers/patients
  • Systematic review and guideline development support
  • Government

The ERG met in October 2017 to discuss the scope of the systematic review and develop the research questions.

Based on the outcomes of the October ERG meeting, four main clinical questions (and two sub questions) were chosen for evidence review.

The NBA released a Request for Tender (RFT) for expertise in systematic review and guideline development processes for the review and update of the Guidelines on 23 October 2017. The RFT closed on 17 November 2017 and an assessment of tenders is currently underway. The NBA expects contracts to be executed with the successful tenderer in February 2018.

The NBA and ERG will remain cognisant of the existing Rh D antenatal prophylaxis program throughout the guideline development process.