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- Anti-D Ig is no longer necessary in women with threatened miscarriage with
a viable fetus and cessation of bleeding before 12 weeks' gestation (1)
- "..evidence that women are sensitised after uterine bleeding in
the first 12 weeks of pregnancy where the fetus is viable and the pregnancy
continues is scant though there are very rare examples.. Against this
background, routine administration of anti-D Ig cannot be recommended.
However it may be prudent to administer anti-D Ig where bleeding is heavy
or repeated or where there is associated abdominal pain particularly if
these events occur as gestation approaches 12 weeks. The period of gestation
should be confirmed by ultrasound..."
NICE state with respect to use of Anti-D rhesus prophylaxis in ectopic pregnancy
and miscarriage (2)
- offer anti-D rhesus prophylaxis at a dose of 250 IU (50 micrograms) to all
rhesus negative women who have a surgical procedure to manage an ectopic pregnancy
or a miscarriage
- do not offer anti-D rhesus prophylaxis to women who:
- receive solely medical management for an ectopic pregnancy or miscarriage
- have a threatened miscarriage or
- have a complete miscarriage or
- have a pregnancy of unknown location
- do not use a Kleihauer test for quantifying feto-maternal haemorrhage
- Royal College of Obstetricians and Gynaecologists. Clinical Green Top Guidelines
(22) - Use of Anti-D Immunoglobulin for Rh Prophylaxis - Revised May 2002.
NICE (December 2012).Ectopic
pregnancy and miscarriage
Last reviewed 01/2018