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Should Rh (D) immunoglobulin be given for a first trimester spontaneous miscarriage, without a curette?

April 26, 2017curette given immunoglobulin miscarriage Rh spontaneous trimester

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Should Rh (D) immunoglobulin be given for a first trimester spontaneous miscarriage, without a curette?

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The NHMRC Report (2003) states that there is doubt concerning the risk of sensitisation associated with bleeding in a spontaneous abortion before 12 weeks. This means that it is unclear whether or not there is a risk of sensitisation before 12 weeks. The NHMRC report (2003) recommends that a dose of 250 IU Rh (D) immunoglobulin should be offered to every Rh (D) negative woman with no preformed anti-D antibodies to ensure adequate protection against immunisation for miscarriage (up to and including 12 weeks’ gestation). The NHMRC Report (2003) strongly recommends that women undergoing termination of pregnancy be tested to determine their Rh (D) type, to avoid unnecessary use of Rh (D) immunoglobulin. Note: the UK RCOG do not recommend routine administration of anti D for threatened miscarriage with a viable fetus <12 weeks, nor for spontaneous miscarriage without instrumentation to evacuate the products of conception.