A 22-year-old presents with 8 weeks amenorrhoea and an intrauterine pregnancy on scan. She requests medical abortion. Her rhesus blood group is O negative. Regarding anti-D administration in medical abortion before 10 weeks, current guidance (RCOG 2023) recommends:
- A Anti-D 250 IU must be given within 72 hours in all Rh-negative women having medical abortion
- B Anti-D 500 IU is required only if surgical evacuation follows failed medical abortion
- C Anti-D is not routinely required for medical abortion at <10 weeks gestation ✓
- D Anti-D is required at <10 weeks only if there is heavy bleeding with passage of products
Correct answer: C. Anti-D is not routinely required for medical abortion at <10 weeks gestation
Explanation
RCOG Green-top Guideline 2023 states that anti-D prophylaxis is NOT routinely recommended for medical management of miscarriage or medical abortion at less than 10 weeks gestation, as feto-maternal haemorrhage at this gestation with medical abortion is minimal and the risk of sensitisation is negligible. This represents a change from older guidelines that recommended anti-D at all gestations. Anti-D is still required for surgical procedures and beyond 10 weeks.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.