A 26-year-old Rh-negative woman who has not been sensitised undergoes laparoscopic salpingectomy for a ruptured tubal ectopic pregnancy. She received no blood products. What additional step is required?
- A Anti-D immunoglobulin 300 microgram within 72 hours ✓
- B No additional step is needed because surgery removes all fetal tissue
- C Kleihauer-Betke testing before any decision on anti-D
- D Intraoperative anti-D given only if feto-maternal haemorrhage exceeds 30 mL
Correct answer: A. Anti-D immunoglobulin 300 microgram within 72 hours
Explanation
Rh-negative, unsensitised women with any ectopic pregnancy require anti-D immunoglobulin 300 microgram (approximately 1500 IU) within 72 hours, whether managed medically or surgically, because trophoblastic tissue can sensitise the mother. Surgery does not eliminate the need since sensitisation occurs from circulating fetal red cells before or during the event. Routine Kleihauer-Betke testing is not required for first-trimester events, and waiting for a large measured haemorrhage would miss clinically significant sensitisation.
Reference: Williams Obstetrics, 26th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.