Do we need to know Rh status for early abortion?

  • Contraception

  • International Clinical Digest
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Takeaway

  • 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.

Key results

  • 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.

Study design

  • Literature review and expert commentary.
  • Funding: None.

Limitations

  • Based on current research, recommendations may change with future studies.