What is the role of Rh immunoglobulin in ectopic pregnancy?

• A. All Rh-negative women should receive Rhogam to prevent alloimmunization regardless of treatment modality
• B. Only after surgical management
• C. Not needed if the mother is Rh-positive
• D. Given only if there is vaginal bleeding

Answer: (A)

Rh immunoglobulin’s job is to prevent the mother’s immune system from forming anti-D antibodies when fetal red blood cells enter her circulation. In an Rh-negative mother, an ectopic pregnancy can cause fetomaternal bleeding, whether or not there is heavy bleeding or a surgical procedure. Giving RhIg after the ectopic event prevents alloimmunization to the D antigen and helps protect future pregnancies from Rh incompatibility problems. This approach is taken regardless of how the ectopic pregnancy is managed (medical or surgical). If the mother is Rh-positive, RhIg isn’t needed. The critical point is the potential exposure to fetal D antigen, not the presence or absence of vaginal bleeding. Timely administration, typically within 72 hours, is ideal.