Pump up the volume? The routine early use of colloid in very preterm infants

ConclusionsThe conference considered present and future issues relating to the management of RhD negative pregnant women in a thorough, balanced, and fair way.Some cynics have criticised the conclusions of the conference panel because the blood products industry were co-sponsors and inevitably this would have been expected to have led to a recommendation to increase the use of anti-D.This is unfair criticism.The evidence of scientific eVectiveness of routine anti-D prophylaxis is very robust and on that conclusion alone, the practice must be recommended.The important question providers of health care will have to answer is: is the present hidden or spontaneous RhD sensitisation rate acceptable?If the answer to that is "no" then oVering routine anti-D prophylaxis to RhD negative pregnant women in the third trimester may be cost eVective in the long term.The dose which seems to be preferred is 500 IU anti-D at 28 and 34 weeks.Finally, and as a more immediate priority, all professionals involved in pregnancy care should improve the implementation of the 1991 guidelines.Specifically, there needs to be a tightening up of the practice of the administration of anti-D to RhD negative women and the use of Kleihauer testing at the time of sensitising events in pregnancy.This advice is especially relevant to those working in accident and emergency departments and in primary care.