A 30-year-old Rh-negative G2P1 mother with an Rh-positive husband gives birth to an Rh-positive infant. The indirect Coombs test during pregnancy was negative. To prevent Rh isoimmunization in future pregnancies, what is the standard recommended administration of Rho(D) immune globulin?

Answer and explanation

Correct answer: A. 300 ug at 28 weeks gestation and within 72 hours postpartum

  1. Step 1: Rh(D) alloimmunization occurs when an Rh-negative mother is exposed to Rh-positive fetal red cells, producing anti-D IgG antibodies.
  2. Step 2: Standard prophylaxis consists of administering 300 ug (1,500 IU) of Rho(D) immune globulin at 28 weeks gestation to non-sensitized Rh-negative mothers.
  3. Step 3: A second dose of 300 ug is administered within 72 hours after delivery if the infant is confirmed to be Rh-positive.
Answer
300 ug at 28 weeks gestation and within 72 hours postpartum.
Why not the others: Antenatal administration at 28 weeks reduces sensitization from 2% down to 0.1%; omitting the 28-week dose leaves antenatal feto-maternal hemorrhage unprotected.

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