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.

In December 2014 there was an update of the Rh(D) Immunoglobulin-VF Product Information by CSL Behring regarding Patients with a Body Mass Index (BMI) >30. BMI was not addressed in the Guidelines on the Prophylactic Use of Rh D Immunoglobulin (Anti-D) in Obstetrics. To support the healthcare community, an expert panel was convened by the Australian Red Cross Blood Service and the NBA and an Expert Panel Consensus Position Statement was developed.

In October 2016, the NBA and the Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) agreed to collaborate to develop a new evidence-based guideline on the prophylactic use of Rh D immunoglobulin (Anti-D) in maternity care.

The development of the guideline 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 finalised the research protocol in July 2018 and the systematic review is underway. The systematic review is investigating universal routine antenatal prophylaxis, sensitising events, targeted prophylaxis and weight-related risk factors. The research questions are accessible via the links below:

The draft guideline will be subject to an open public consultation process in mid-2019 before being finalised.

The new guideline will retain the existing guideline’s policy intent for a national Anti-D antenatal prophylaxis program in addition to providing clinical guidance. Any impact of the evidence findings on the existing prophylaxis program will be considered by the NBA and the Jurisdictional Blood Committee.