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How to Treat Rhesus Negative Woman?

Things to note:
Maternal serum antibodies absent
  • Test for maternal serum antibodies at booking, 28 and 34 weeks gestation.
  • During pregnancy, give prophylactic anti-D immunoglobulin to the mother within 72 hours of a potentially sensitising event.

Medical Treatment:
After a termination of pregnancy (TOP), miscarriage, ectopic pregnancy or amniocentesis:
  • Anti-D immunoglobulin, IM, 100 mcg.
After external cephalic version:
  • Anti-D immunoglobulin, IM, 100 mcg.
At birth, determine the Rh status of the cord blood and request a Coombs test:
  • Cord blood Rh negative - no treatment.
Cord blood Rh positive, Coombs negative:
  • Anti-D immunoglobulin, IM, 100 mcg.
If a large feto-maternal transfusion is suspected:
  • Anti-D immunoglobulin, IM, 300 mcg for every 30 mL transfusion.
    • Maximum dose: 1200 mcg.
Do a maternal blood Kleihauer test.
Rh positive, Coombs positive:
  • In these cases the mother will also have antibodies.
  • Do not administer anti-D immunoglobulin.
Maternal serum antibodies present
  • Consult a specialist.