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Rhesus isoimmunisation prevention — DRCOG MCQ

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HardAntenatal CareRhesus isoimmunisation preventionDRCOG

A 29-year-old rhesus D negative woman at 17 weeks presents with light vaginal bleeding after intercourse. A viable intrauterine pregnancy is confirmed by ultrasound. She is not sensitised and has no abdominal pain. What is the most appropriate management?

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Correct answer: D — Give anti-D immunoglobulin after assessment

Anti-D immunoglobulin is indicated after a potentially sensitising event in an unsensitised rhesus D negative pregnant woman, including antepartum bleeding after the first trimester begins. Routine anti-D at 28 weeks does not replace treatment after a bleeding episode. Kleihauer testing is mainly relevant for quantifying fetomaternal haemorrhage after later gestations or significant trauma. The pearl is that minor-looking bleeding can still be a sensitising event.

Reference: NICE NG201; BCSH/RCOG anti-D guidance