An Rh-negative mother delivers an Rh-positive newborn. It has been 24 hours since delivery. What is the next step?

An Rh-negative mother delivers an Rh-positive newborn. It has been 24 hours since delivery. What is the next step?

• A. Administer RhoGAM within 72 hours postpartum
• B. Start antibiotics
• C. Perform Coombs test
• D. Do nothing

Answer: (A)

Preventing the mother from becoming sensitized to the Rh antigen after exposure to Rh-positive fetal cells during delivery is the key concept. When an Rh-negative mother gives birth to an Rh-positive infant, fetal red blood cells can enter the maternal circulation. If anti-D antibodies develop, they can cause problems in future pregnancies with Rh-positive babies. Giving Rho(D) immune globulin (RhoGAM) within 72 hours after birth binds any remaining fetal Rh-positive cells in the mother’s blood and prevents her immune system from forming antibodies. The 24-hour postpartum window is within the recommended time frame, so this is the appropriate next step. Antibiotics aren’t indicated here unless there’s an infection, and while testing (like a Coombs test) can assess for sensitization, the immediate preventive measure is the RhoGAM administration. Doing nothing would leave the mother at risk for sensitization in future pregnancies.

Preventing the mother from becoming sensitized to the Rh antigen after exposure to Rh-positive fetal cells during delivery is the key concept. When an Rh-negative mother gives birth to an Rh-positive infant, fetal red blood cells can enter the maternal circulation. If anti-D antibodies develop, they can cause problems in future pregnancies with Rh-positive babies. Giving Rho(D) immune globulin (RhoGAM) within 72 hours after birth binds any remaining fetal Rh-positive cells in the mother’s blood and prevents her immune system from forming antibodies. The 24-hour postpartum window is within the recommended time frame, so this is the appropriate next step. Antibiotics aren’t indicated here unless there’s an infection, and while testing (like a Coombs test) can assess for sensitization, the immediate preventive measure is the RhoGAM administration. Doing nothing would leave the mother at risk for sensitization in future pregnancies.