A 24-year-old Rh-negative woman with an unruptured left tubal ectopic pregnancy undergoes successful medical management with methotrexate. Which of the following is indicated regarding Rh immunoglobulin (Anti-D) administration?
- A Anti-D is not indicated because the pregnancy is ectopic and non-viable
- B Anti-D is indicated for all Rh-negative women with ectopic pregnancy regardless of gestational age ✓
- C Anti-D 50 μg is indicated only if the gestation is less than 12 weeks
- D Anti-D 300 μg is indicated only if the gestation is at or beyond 12 weeks
Correct answer: B. Anti-D is indicated for all Rh-negative women with ectopic pregnancy regardless of gestational age
Explanation
ACOG and standard obstetric guidelines recommend Rh immunoglobulin (Anti-D) for all Rh-negative women with any bleeding or risk of fetomaternal hemorrhage in early pregnancy, including ectopic pregnancy, at a dose of 50 μg for gestations up to 12 weeks. The key point is that ectopic pregnancy is an indication, not a contraindication, for Rh prophylaxis.
Reference: Williams Obstetrics, 26th ed.
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