GuidelinesOther guideline
Rhesus Incompatibility
The guidelines recommend management of common obstetric conditions at primary and referral level, based on local experience and evidence-based practice. They are not intended as strict protocols nor as standard operating procedures, but rather as a guide to safe effective management of common obstetric problems. The guidelines should be most useful to interns, medical officers and registrars.
Rapid rhesus (D) blood group testing is done on all pregnant women at the first antenatal visit, or at delivery in unbooked women. Rhesus-positive women need no further specific management.
If a woman is pregnant & Rhesus-negative, send blood for atypical antibody testing at 26, 32 & 36 weeks:
- If antibodies are found, refer the woman to the Fetal Medicine Unit for further management (fetal middle cerebral artery Doppler, cordocentesis & transfusion if necessary, elective delivery as advised by the Fetal Medicine Unit)
- If no antibodies are found, give prophylactic anti-D 100 mcg IM as follows:
- If amniocentesis or external cephalic version is performed
- If there is antepartum haemorrhage
- If the woman suffers any abdominal trauma
- After delivery to all Rhesus-negative mothers, if the baby is Rhesus-positive or its Rhesus status is unknown
- Following termination of pregnancy (TOP), miscarriage before 20 weeks, or ectopic pregnancy, give anti-D 50 mcg IM