Recommendations

Document Overview

Design and created by Guideline Central in participation with the Society of Family Planning.

Rh Testing in Early Pregnancy

Society of Family Planning

Publication Date: Jul 20, 2022

Page Last Updated: Mar 23, 2026

Document Overview

Full Text Guideline: www.contraceptionjournal.org/article/S0010-7824(22)00197-4/fulltext

Source Citation: Horvath S, Goyal V, Traxler S, Prager S. Society of Family Planning committee consensus on Rh testing in early pregnancy. Contraception. 2022 Jul 21:S0010-7824(22)00197-4. doi: 10.1016/j.contraception.2022.07.002. Epub ahead of print. PMID: 35872236.

Document Objectives: Historical evidence that fetal red blood cell (RBC) exposure during early spontaneous or induced abortion can cause maternal Rh sensitization is limited. A close reading of these studies indicates that forgoing Rh immunoglobulin administration before 12-weeks gestation is highly unlikely to increase risk of Rh (D) antibody development, and recent studies indicate that fetal RBC exposure during aspiration abortion <12 weeks gestation is below the calculated threshold to cause maternal Rh sensitization, and the amount of fetomaternal hemorrhage during dilation and evacuation procedures up to 18-weeks gestation is adequately treated with 100-mcg of Rh immunoglobulin. We provide updated recommendations for Rh immunoglobulin administration based on this new evidence.

Diseases/Conditions (MeSH)

D011247 - Pregnancy

D012234 - Rho Factor

Gestational age	Recommendation for Rh immunoglobulin
<12 weeks	No administration recommended routinely for spontaneous or induced abortion.
<12 weeks	50 mcg/ 250 IU for ectopic pregnancy, sharp curettage, or other invasive procedures
13 to ≤18 weeks	100-mcg/ 500 IU dose
>18 weeks	300-mcg/ 1500 IU dose