Question

A 28-year-old Rh negative G1P0 woman at eight weeks gestation presents to the clinic for a first prenatal visit. Which of the following is the current recommendation for RhoGAM administration to prevent Rh isoimmunization?

A. Routine administration for every Rh-sensitized woman at term
B. Administration for Rh-negative patients with no Rh antibodies at 28 weeks
C. Administration for every Rh-negative woman who delivers an Rh-negative infant
D. Routine administration for all Rh-negative patients during first trimester
E. Routine administration for all Rh-negative patients during each trimester

Answer 1

B. Administration for Rh-negative patients with no Rh antibodies at 28 weeks

Step-by-step explanation:

Rhesus (Rh) negative mothers can develop Rh antibodies if they have an Rh-positive newborn, causing haemolytic disease of the newborn (HDN) in subsequent pregnancies.

Administering RhoGAM (anti-D immunoglobulin) to Rh negative women within 72 hours of giving birth to an Rh-positive baby is an effective and ideal way of preventing RhD alloimmunization.

However, Rhesus alloimmunization occurring in the third trimester due to occult transplacental haemorrhages will not be prevented by postpartum anti-D. Therefore, the best option is to administer it before birth at 28 weeks.