The main purpose of this site is to create an interactive forum in which GP Mentors, Educators, and Doctors who are preparing for their RACGP exams to exchange ideas and strategies. It will also serve as a medium in which established GPs can post in their questions for our panel of Specialists and Allied Health to answer. In addition, we are hoping to promote more Mental Health awareness and upskilling in General Practice. We are independent of the RACGP.
Question time for Dr Michaela Lee Brisbane's Obstetrician and Gynaecologist on "What is the new guideline for the use of anti D in pregnant women who are Rh neg?"
Dr Michaela Lee
The guidelines regarding the first trimester have been recently amended:
Sensitising events in first trimester <13/40: A dose of 250IU RhD is recommended for:
Miscarriage (surgical, medical)
Chorionic villus sampling
There is insufficient evidence to support the use of RH D immunoglobulin in PV bleeding prior to 12 weeks gestation in an ongoing pregnancy (eg threatening miscarriage, conservative management for miscarriage)
That means it is up to the doctor to give anti D or not. Personally, I think there is no need to give anti D for threatened MC or conservative management of miscarriage under 8/40.
In second and third trimester:
Prophylactic RH D at 28/40 and 32-34/40 is recommended. 625IU
625IU for any possible sensitizing events eg Trauma, APH, motor vehicle accident