A 31-year-old Rh(D)-negative pregnant woman at 28 weeks gestation has a negative indirect Coombs test (unsensitized). What prophylactic medication is routinely administered to prevent Rh alloimmunization (hemolytic disease of the newborn)?
Answer and explanation
Correct answer: B. Anti-D immune globulin (RhoGAM 300 mcg / 1,500 IU)
- Step 1: Rh(D) alloimmunization occurs when maternal antibodies form against fetal Rh-positive red cells crossing the placenta.
- Step 2: Routine prophylaxis with Anti-D immune globulin is administered at 28 weeks gestation and within 72 hours post-delivery if the newborn is confirmed Rh-positive.
Answer
Anti-D immune globulin (RhoGAM 300 mcg / 1,500 IU).
Why not the others: 'Intravenous immunoglobulin (IVIG) 2 g/kg' is used in established maternal autoimmune thrombocytopenia, not Rh prophylaxis; 'Oral dexamethasone' is used for impending preterm delivery; 'Subcutaneous unfractionated heparin' treats venous thromboembolism.
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