For an RhD-negative woman who is not already sensitised, anti-D immunoglobulin should be given after a potentially sensitising event, such as antepartum bleeding, abdominal trauma, external cephalic version or invasive prenatal testing, ideally within 72 hours. After 20 weeks, a test of fetomaternal haemorrhage guides whether more is needed. If the window has passed, giving it late may still offer some protection.
- Check RhD status and antibody screen at booking for every woman.
- Give anti-D within 72 hours of a sensitising event in non-sensitised RhD-negative women.
- After 20 weeks, quantify fetomaternal haemorrhage to guide the dose.
- Do not withhold anti-D only because 72 hours have passed.
Why it matters
Missed or late doses remain a preventable cause of anti-D sensitisation.
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