Obstetrics & Gynaecology — DRCOG MCQ

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A 32-year-old woman attends antenatal clinic. She is RhD negative. What is the recommended prophylaxis to prevent haemolytic disease of the newborn?

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Correct answer: A — Anti-D immunoglobulin at 28 and 34 weeks

An RhD-negative pregnant woman who is not already sensitised should receive routine antenatal anti-D immunoglobulin prophylaxis. Anti-D prevents maternal RhD alloimmunisation after occult fetomaternal haemorrhage, reducing the risk of haemolytic disease of the fetus and newborn in an RhD-positive fetus and in future pregnancies. The recommended two-dose regimen is anti-D immunoglobulin at 28 and 34 weeks’ gestation. Prophylaxis is not delayed until bleeding or delivery; additional anti-D is given after potentially sensitising events and postpartum if the baby is RhD positive.

Reference: NICE Technology Appraisal TA156: Routine antenatal anti-D prophylaxis for women who are rhesus D negative (2008, current guidance). https://www.nice.org.uk/guidance/ta156