- Rh testing and anti-D immunoglobulin may not be necessary with early abortion.
Why this matters
- Early abortion has expanded into homes and offices without lab capabilities, making Rh testing a barrier to receiving care.
- WHO recommends that where Rh D-negative status is prevalent and anti-D immunoglobulin is routinely provided, testing should be administered.
- Early Rh testing is not universal.
- Evidence on the need for testing and treatment in early pregnancy is lacking.
- Research using flow cytometry was unable to detect fetal cells in maternal circulation before and after aspirations for induced and spontaneous abortion at 5-12 weeks gestation.
- A large study in medical abortions up to 10 weeks is underway.
- Testing and treating patients with anti-D immunoglobulin in early pregnancy has demonstrated no benefit and carries risk, is not practiced in other countries, and adds cost and complexity to the abortion procedure.
- The National Abortion Federation's Clinical Policies Committee recommends that it is reasonable to forgo Rh testing and anti-D immunoglobulin for women having any type of induced abortion before 8 weeks from last menstrual period.
- Literature review and expert commentary.
- Funding: None.
- Based on current research, recommendations may change with future studies.