An Rh-negative unsensitized woman at 32 weeks presents with antepartum hemorrhage from a confirmed placenta previa. After stabilization, what additional measure is required?

• A Intrauterine transfusion to the fetus
• B Anti-D immunoglobulin 300 microgram intramuscularly within 72 hours ✓
• C Kleihauer-Betke test only if bleeding exceeds 1000 mL
• D No intervention, because fetomaternal hemorrhage does not occur in placenta previa

Explanation

Any significant antepartum hemorrhage can cause fetomaternal bleeding, so an unsensitized Rh-negative woman requires anti-D immunoglobulin 300 microgram (approximately 1500 IU) within 72 hours of the episode. A Kleihauer-Betke test quantifies the volume of fetomaternal hemorrhage and guides additional dosing but does not replace prophylaxis. Intrauterine transfusion is reserved for established severe fetal anemia, not routine prophylaxis.

Reference: Fernando Arias' Practical Guide to High-Risk Pregnancy and Delivery, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.