An unsensitized Rh-negative woman undergoes suction evacuation for a missed miscarriage at 9 weeks of gestation. According to Indian practice guidelines, what dose of anti-D immunoglobulin should she receive?

• A 300 mcg intramuscularly
• B 120 mcg intramuscularly
• C 50 mcg intramuscularly ✓
• D No anti-D is required before 12 weeks

Explanation

For sensitizing events before 12 weeks of gestation, fetomaternal hemorrhage volumes are small and a 50 mcg (250 IU) dose of anti-D immunoglobulin is sufficient. The full 300 mcg (1200 to 1500 IU) dose is reserved for events after 12 weeks, delivery, and any event with suspected large fetomaternal hemorrhage. Although early fetal red cells carry little D antigen, sensitization can still occur, so immunoprophylaxis is required following miscarriage, ectopic pregnancy, and molar evacuation in unsensitized Rh-negative women.

Reference: Ian Donald's Practical Obstetric Problems, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.