Education And Debate

Lesson of the Week: Importance of accurate assessment of fetomaternal haemorrhage after late abortions

BMJ 1996; 313 doi: http://dx.doi.org/10.1136/bmj.313.7066.1200a (Published 09 November 1996) Cite this as: BMJ 1996;313:1200

This article has a correction. Please see:

  1. Imelda Bromilow, clinical scientista,
  2. J K M Duguid, consultant haematologista,
  3. S Walkinshaw, consultant haematologistb
  1. a National Blood Service, Mersey and North Wales Centre, Liverpool L7 8TW
  2. b Liverpool Women's Hospital, Liverpool L8 7SS
  1. Correspondence to: Dr Duguid.
  • Accepted 10 September 1996

Anti-D immunoglobulin is routinely administered to RhD negative women after an abortion. Before 20 weeks of gestation 25 IU of anti-D immunoglobulin should be given and after 20 weeks of gestation 500 IU. The Kleihauer stain test should be routinely performed to assess the adequacy of this dose.1 RhD typing of the aborted fetus is not usually performed.

Fetal blood after late abortion in RhD negative women should be RhD typed to ensure appropriate anti-D immunoglobulin dosage

We report a case in which large doses of anti-D immunoglobulin were given inappropriately because the Kleihauer test detects only fetal haemoglobin; further testing with flow cytometry showed that the abortus was RhD negative.

Case report

A pregnant woman …

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