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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    
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.
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.
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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