Polyclonal Anti-D Antibodies Significantly Reduce the Rate of Miscarriages in Rh(D) positive Women with Recurrent Pregnancy loss

Objective: Coating of autologous red blood cells (RBCs) with polyclonal antibodies to Rh(D) antigen may result in an immunomodulation and improved outcome in Rh(D) positive women with recurrent pregnancy loss (RPL). Design: Retrospective data analysis. Setting: Rh(D) positive women with a history of RPL and ineffective treatment with low molecular weight heparin (LMWH) and/or aspirin Methods: Anti-D (300 µg) was given subcutaneously to 60 women either prior to pregnancy and/or two times within 12 weeks of gestation. Main outcome measures: Births of healthy child/children. Results: Treatment with Anti-D resulted in successful pregnancies in 67% of all cases. The remaining women had only aborts (23%) or did not become pregnant (10%). None of the treated women has developed anaemia due to this treatment or any other significant adverse reaction. The rate of successful pregnancies does not appear to be influenced by the administration of: Anti-D prior to pregnancy, age, thrombophilia or previous alive births. Conclusion: The improved outcome following the administration of Anti-D in women with RPL might be explained by immune modulations induced by different immune reactions including polarization of decidual macrophages. The results obtained in this study clearly indicate that Anti-D is safe and highly effective in treatment of Rh(D) positive women with RPL. However, further studies are required to support our results and to find out the optimal dose and timing of Anti-D administration. Funding: There was no funding included. Key words: abort, Anti-D, aspirin, low molecular weight heparin, new treatment, recurrent pregnancy loss