**5.1 Recommendations**

We recommend that the Nigerian government should implement the following evidence-based best practices (British Committee for Standards in Haematology [152–155].


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*Distribution of Clinically Relevant Blood Group Antigens among Nigerians…*

following a sensitising event to prevent HDFN.

red cells to ensure that they meet the requirements for intrauterine, exchange

8.Facilities for the implementation of alloantibody titration and quantification should be provided for pregnant women with a clinically significant, HDFN

9.There is need for the provision of facilities for fetomaternal haemorrhage testing to facilitate the administration of optimal amount of anti-D prophylaxis

10. Knowledge of anti-D prophylaxis and management of women with clinically significant antibodies among Obstetricians, Laboratory of Biomedical Scientist, Midwives, Traditional Birth Attendants, Pharmacists and Nurses in Nigeria and other countries in Africa needs to be improved. This will facilitate quality antenatal and postnatal care offered particularly to Rh-negative preg-

nant women and those with clinically significant alloantibodies.

often not required for sensitising events at <12weeks gestation.

11. That anti-D prophylaxis be provided in Rhesus D negative pregnant pregnancies <12weeks gestation, following ectopic pregnancy, molar pregnancy, therapeutic termination of pregnancy. FMH haemorrhage (FMH) testing is

12. That for all potentially sensitising events occurring between 12- and 20-weeks' gestation, prophylaxis should be administered within 72h of the event without

13. That for potentially sensitising events after 20weeks gestation, prophylaxis should be administered within 72h of the event along with testing for FMH. This is to determine if additional dose of anti-D Ig is required for a

14. That in the event of an intrauterine foetal death (IUFD), where no sample can be obtained from the baby or foetus, an appropriate dose of prophylactic anti-D should be administered to Rhesus D negative, previously non-sensitised women within 72h of the *diagnosis of IUFD*, irrespective of the time of subse-

15. That following intra-operative cell salvage (ICS) during Caesarean section in D negative, previously non-sensitised women, and where cord blood group is confirmed as D positive (or unknown), a minimum dose of 1500 IU prophylactic anti-D should be administered following the re-infusion of salvaged red cells. Also, the maternal sample should be taken for estimation of FMH 30–45min after reinfusion to confirm if a further dose of anti-D Ig is required.

16. That in cases of therapeutic termination of pregnancy (abortion), whether by surgical or medical methods, and regardless of gestational age, all previously non-sensitised D negative women should receive a dose of prophylactic anti-D

17. That anti-D prophylaxis should be administered to all cases of ectopic pregnancy in previously non-sensitised, D negative women regardless of the mode

*DOI: http://dx.doi.org/10.5772/intechopen.90372*

and top up transfusion.

causing alloantibody.

need for FMH testing.

significant bleed.

quent delivery.

of management.

within 72h of having the procedures.

red cells to ensure that they meet the requirements for intrauterine, exchange and top up transfusion.

