Category: Obstetrics & Gynecology
Keywords: alloimmunization, pregnancy, RhoGAM (PubMed Search)
Posted: 10/10/2024 by Michele Callahan, MD
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Historically, there has been limited and inconclusive data regarding the utility of Rh (D) immunoglobulin (RhIg) in preventing alloimmunization for patients with early pregnancy loss or abortion at <12 weeks gestation. Although previous guidelines recommended routine administration of RhIg in Rh(-) patients after abortion of pregnancy loss at <12 weeks gestation, updated recommendations have been published as of September 2024.
The following are the updated recommendations from ACOG for patients who are less than 12 0/7 weeks gestation and undergoing abortion (managed with uterine aspiration or medication) or experiencing pregnancy loss (spontaneous or managed with aspiration or medication):
-ACOG recommends forgoing routine Rh testing and RhIg prophylaxis
-Rh testing and administration of RhIg can be considered on an individual basis with the help of shared-decision making regarding potential risks and benefits
These updated recommendations are based on recent studies that show a very low likelihood (although not entirely zero) of Rh alloimmunization associated with these populations. Many other Obstetric expert guidelines (such as those from the World Health Organization, Royal College of Obstetricians and Gynaecologists, and the Society of Family Planning) mirror these recommendations.
Summary: Consider shared decision-making regarding RhoGAM administration in patients who have an abortion or early pregnancy loss at <12 weeks gestation.
Rh D Immune Globulin Administration After Abortion or Pregnancy Loss at Less Than 12 Weeks of Gestation. Obstetrics & Gynecology ():10.1097/AOG.0000000000005733, September 10, 2024. | DOI: 10.1097/AOG.0000000000005733
