{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T15:08:33Z","timestamp":1775833713518,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,12,25]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In order to develop the 2019 National Institute for Health and Care Excellence (NICE) national guideline on abortion care for the National Health Service<jats:sup>1<\/jats:sup> we undertook a systematic review comparing anti-D prophylaxis to no prophylaxis in rhesus D (RhD)-negative women undergoing medical or surgical abortion of pregnancy at \u226413<jats:sup>+6<\/jats:sup> weeks\u2019 gestation<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We searched Embase, Medline and the Cochrane Library on 19 October 2018. We also consulted experts and checked reference lists for any missed trials. Eligible studies were randomised controlled trials and non-randomised comparative studies, published in English from 1985 onwards, comparing anti-D prophylaxis to no anti-D prophylaxis in RhD-negative women undergoing medical or surgical abortion at \u226413<jats:sup>+6<\/jats:sup> weeks\u2019 gestation, and reporting subsequent anti-D isoimmunisation\/sensitisation or subsequent affected pregnancy. These outcomes were to be analysed as risk ratios in Review Manager 5.3 using the Mantel-Haenszel statistical method and a fixed or random effect model. The overall quality of the evidence was planned to be assessed using GRADE.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The search identified 426 potentially relevant studies of which none met the inclusion criteria. Recommendations for practice were therefore based on the clinical expertise of the guideline committee.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>(1) Offer anti-D prophylaxis to women who are Rhesus D negative who are having an abortion after 10<jats:sup>+0<\/jats:sup> weeks\u2019 gestation. (2) Do not offer anti-D prophylaxis to women who are having a medical abortion up to and including 10<jats:sup>+0<\/jats:sup> weeks\u2019 gestation. (3) Consider anti-D prophylaxis for women who are rhesus D negative and are having a surgical abortion up to and including 10<jats:sup>+0<\/jats:sup> weeks\u2019 gestation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2019-200536","type":"journal-article","created":{"date-parts":[[2020,1,20]],"date-time":"2020-01-20T17:19:23Z","timestamp":1579540763000},"page":"84-89","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Anti-D prophylaxis for rhesus D (RhD)-negative women having an abortion of a pregnancy up to 13<sup>+6<\/sup> weeks\u2019 gestation: a systematic review and new NICE consensus guidelines"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4503-6870","authenticated-orcid":false,"given":"Mia","family":"Schmidt-Hansen","sequence":"first","affiliation":[{"name":"National Guideline Alliance, Royal College of Obstetricians & Gynaecologists, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-5973","authenticated-orcid":false,"given":"Jonathan","family":"Lord","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, Royal Cornwall Hospitals NHS Trust, Truro, Cornwall, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James","family":"Hawkins","sequence":"additional","affiliation":[{"name":"National Guideline Alliance, Royal College of Obstetricians & Gynaecologists, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Cameron","sequence":"additional","affiliation":[{"name":"Sexual and Reproductive Health Services, NHS Lothian, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anuja","family":"Pandey","sequence":"additional","affiliation":[{"name":"National Guideline Alliance, Royal College of Obstetricians & Gynaecologists, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise","family":"Hasler","sequence":"additional","affiliation":[{"name":"National Guideline Alliance, Royal College of Obstetricians & Gynaecologists, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fiona","family":"Regan","sequence":"additional","affiliation":[{"name":"Department of Haematology, Imperial College Healthcare NHS Trust and NHS Blood & Transplant, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,1,20]]},"reference":[{"key":"2025090511095033000_47.2.84.1","unstructured":"National Institute for Health and Care Excellence (NICE) . Abortion care, 2019. Available: https:\/\/www.nice.org.uk\/guidance\/NG140 [Accessed 17 Oct 2019]."},{"key":"2025090511095033000_47.2.84.2","first-page":"514","article-title":"Prenatal non-invasive foetal RhD genotyping: diagnostic accuracy of a test as a guide for appropriate administration of antenatal anti-D immunoprophylaxis","volume":"16","author":"Manfroi","year":"2018","journal-title":"Blood Transfus"},{"key":"2025090511095033000_47.2.84.3","unstructured":"National Institute for Health and Care Excellence (NICE) . Routine antenatal anti-D prophylaxis for women who are rhesus D negative (Report No. TA156). London, UK: NICE, 2008."},{"key":"2025090511095033000_47.2.84.4","unstructured":"Department of Health and Social Care . Abortion statistics, England and Wales: 2018. London, UK: Department of Health and Social Care, 2019."},{"key":"2025090511095033000_47.2.84.5","doi-asserted-by":"crossref","first-page":"36","DOI":"10.18773\/austprescr.2000.037","article-title":"Wanted: Rh D negative donors","volume":"23","author":"Dean","year":"2000","journal-title":"Aust Prescr"},{"key":"2025090511095033000_47.2.84.6","unstructured":"Higgins JPT , Green S , eds. Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. handbook.cochrane.org"},{"key":"2025090511095033000_47.2.84.7","unstructured":"Wells GA , Shea B , O\u2019Connell . Newcastel-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Available: www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp [Accessed 20 Jun 2018]."},{"key":"2025090511095033000_47.2.84.8","unstructured":"The Nordic Cochrane Centre . Review Manager (RevMan) [Computer program]. Version 5.3. Copenhagen, Denmark: The Cochrane Collaboration, 2014."},{"key":"2025090511095033000_47.2.84.9","unstructured":"GRADEpro Guideline Development Tool [Software] [Computer program]. McMaster University, 2015 (developed by Evidence Prime, Inc.), 2015. Available: www.gradepro.org"},{"key":"2025090511095033000_47.2.84.10","unstructured":"National Institute for Health and Care Excellence , 2019. Available: https:\/\/www.nice.org.uk\/guidance\/ng140\/evidence\/c-antid-prophylaxis-for-women-up-to-136-weeks-gestation-pdf-6905052975 [Accessed 13 Jan 2020]."},{"key":"2025090511095033000_47.2.84.11","unstructured":"Swedish Society of Obstetrics and Gynecology . Inducerad abort (Report No. 78). Stockholm, Sweden: Svensk f\u00f6rening f\u00f6r Obstetrik & Gynekologi, 2018."},{"key":"2025090511095033000_47.2.84.12","unstructured":"Bj\u00f8rge L , L\u00f8keland M , Oppegaard K . Provosert abort [Induced abortion]. Oslo, Norway: Norsk gynekologisk forening, 2017."},{"key":"2025090511095033000_47.2.84.13","unstructured":"Sundhedsstyrelsen . Anbefalinger For Svangreomsorgen [Recommendations For Prenatal Care] (Report No. 9.2.3 - Indications for treatment with anti-D immunoglobulin for non-immunized RhD negative pregnant). Copenhagen, Denmark: Sundhedsstyrelsen [Danish National Board of Health], 2013."},{"key":"2025090511095033000_47.2.84.14","unstructured":"American College of Obstetricians and Gynecologists . Prevention of Rh D alloimmunization (practice Bulletin 181), 2017. Available: https:\/\/www.hypermunes.com\/documents\/31474919\/31475109\/2017_ACOG_+RhD_Guidelines.pdf\/bdc6b897-9412-4a28-995c-2c0c706ac5dc [Accessed 17 Oct 2019]."},{"key":"2025090511095033000_47.2.84.15","unstructured":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) . Guidelines for the use of Rh(D) immunoglobulin (anti-D) in obstetrics in Australia. East Melbourne, Australia: RANZCOG, 2015."},{"key":"2025090511095033000_47.2.84.16","unstructured":"New Zealand Blood Service . Use of Rh D immunoglobulin during pregnancy and the post-partum period (Id: 111G130); 2013. https:\/\/www.nzblood.co.nz\/assets\/Transfusion-Medicine\/PDFs\/USE-OF-RH-D-IMMUNOGLOBULIN-DURING-PREGNANCY-AND-THE-POST-PARTUM-PERIOD-111G130.pdf"},{"key":"2025090511095033000_47.2.84.17","first-page":"1S123","article-title":"[Prevention of fetomaternal rhesus-D allo-immunization. Practical aspects]","volume":"35","author":"Cortey","year":"2006","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"2025090511095033000_47.2.84.18","doi-asserted-by":"crossref","DOI":"10.1016\/j.conx.2018.100001","article-title":"Can we safely stop testing for Rh status and immunizing Rh-negative women having early abortions? A comparison of Rh alloimmunization in Canada and the Netherlands","volume":"1","author":"Wiebe","year":"2019","journal-title":"Contraception"},{"key":"2025090511095033000_47.2.84.19","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1016\/j.contraception.2019.02.008","article-title":"Foregoing Rh testing and anti-D immunoglobulin for women presenting for early abortion: a recommendation from the National Abortion Federation's Clinical Policies Committee","volume":"99","author":"Mark","year":"2019","journal-title":"Contraception"},{"key":"2025090511095033000_47.2.84.20","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2003.208"},{"key":"2025090511095033000_47.2.84.21","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.contraception.2019.03.051","article-title":"\"Provoked\" feto-maternal hemorrhage may represent insensible cell exchange in pregnancies from 6 to 22 weeks gestational age","volume":"100","author":"Hollenbach","year":"2019","journal-title":"Contraception"},{"key":"2025090511095033000_47.2.84.22","unstructured":"National Institute for Health and Care Excellence (NICE) . 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ISBN: 978 92 4 154843 4."}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2019-200536","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T18:34:20Z","timestamp":1757097260000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2019-200536"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,20]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2021,4,13]]},"published-print":{"date-parts":[[2021,4]]}},"alternative-id":["10.1136\/bmjsrh-2019-200536"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2019-200536","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,20]]}}}