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Pharmacokinetics of 250 μg anti-D IgG in the third trimester of pregnancy: an observational study.
MedLine Citation:
PMID:  22352370     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Objective. We present a pharmacokinetic study evaluating a single intramuscular dose of 250 μg anti-D immunoglobulin in the third trimester of pregnancy. The aim of the study was to determine the kinetic profile and duration of detectable levels of anti-D. Design. Prospective observational study. Setting. Antenatal outpatient clinic. Population. Healthy RhD negative pregnant women with an RHD positive fetus. Material and methods. Serial plasma anti-D quantitations following antenatal administration of anti-D immunoglobulin were performed using flow cytometry. Kinetic profiles for anti-D levels were generated from the concentration values at pre-set sampling timepoints. The half-lives were calculated by linear regression analysis. Main outcome measures. Time versus concentration profile, half-life, anti-D concentration ≥ 1 ng/mL close to term. Results. Maximum plasma concentration of anti-D was usually seen at 3-10 days post-injection with a median value of 25 ng/mL. The half-life varied between individuals with a median of 23 days. We found detectable levels of anti-D IgG within two weeks of parturition in 11/12 women (C(last) ). Conclusion. The preparation of anti-D immunoglobulin used in the present study, if administrated in pregnancy week 28-30, is associated with detectable levels of anti-D in most women at the time of delivery. Although the halftime is 23 days it is an open question if all mothers have adequate anti-D concentrations at term. Alternative strategies may be evaluated in the future with repeated administration of antenatal prophylaxis at term rather than conventional postpartum administration of anti D.
Authors:
Eleonor Tiblad; Agneta Wikman; Anders Rane; Yvonne Jansson; Magnus Westgren
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-21
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  -     ISSN:  1600-0412     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-2-22     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 The Authors AOGS© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.
Affiliation:
Department of Obstetrics and Gynecology, Department of Immunology and Transfusion Medicine, and Department of Clinical Pharmacology, Karolinska University Hospital and Karolinska Institute, Stockholm. Sweden.
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