{"id":453,"count":1,"description":"<style>\r\n  .lrisk-wrap { display: grid; grid-template-columns: 5rem 1fr; row-gap: 0.75rem; column-gap: 0.5rem; }\r\n  .lrisk-title { grid-column: 1 \/ -1; font-weight: 600; font-size: 1.05rem; margin-bottom: 0.25rem; }\r\n  .lrisk-code { font-weight: 600; white-space: nowrap; }\r\n  .lrisk-text { line-height: 1.5; }\r\n  .lrisk-text ul { margin: .5rem 0 .25rem 1.25rem; }\r\n.hrisk-text ul,\r\n.lrisk-text ul {\r\n  list-style: disc !important;       \/* show bullets *\/\r\n  list-style-position: outside;      \/* normal positioning *\/\r\n  padding-left: 1.25rem;             \/* indent *\/\r\n  margin-left: 0;                    \/* optional *\/ }\r\n<\/style>\r\n\r\n<div class=\"lrisk-wrap\">\r\n  <div class=\"lrisk-title\">RhD, RhIg & FMH Clinical Guidance (Low Risk Statements)<\/div>\r\n\r\n  <div class=\"lrisk-code\">L1<\/div>\r\n  <div class=\"lrisk-text\">For routine care, prenatal testing for ABO, RhD, and antibody screen is recommended after 8 weeks gestation, preferably between 11 and 14 weeks.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L2<\/div>\r\n  <div class=\"lrisk-text\">A routine ABO, RhD and antibody screen may not be necessary at 28 weeks gestation for either RhD positive or RhD negative pregnancies.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L3<\/div>\r\n  <div class=\"lrisk-text\">Antibody screening is suggested for all pregnancies (RhD negative and RhD positive) following a sensitizing event or after maternal RBC transfusion.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L4<\/div>\r\n  <div class=\"lrisk-text\">\r\n    Maternal ABO, RhD, and antibody screen at the time of delivery is only recommended when:\r\n    <ul>\r\n      <li>there is no prior test during the current pregnancy; and\/or<\/li>\r\n      <li>there is a clinically significant antibody; and\/or<\/li>\r\n      <li>the risk of maternal transfusion is increased; and\/or<\/li>\r\n      <li>the risk of neonatal transfusion is increased.<\/li>\r\n    <\/ul>\r\n  <\/div>\r\n\r\n  <div class=\"lrisk-code\">L5<\/div>\r\n  <div class=\"lrisk-text\">RHD genotyping is recommended in any pregnant person with weak or variably reactive RhD typing.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L6<\/div>\r\n  <div class=\"lrisk-text\">It is recommended that pregnancies with weak or indeterminant RhD and without available RHD genotype results be considered RhD negative until genotyping results are available.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L7<\/div>\r\n  <div class=\"lrisk-text\">For any pregnancy less than 12 weeks gestational age (12 weeks 0 days) experiencing an abortion (threatened, spontaneous or therapeutic), an ABO, RhD, and antibody screen are not recommended and RhIg is not required.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L8<\/div>\r\n  <div class=\"lrisk-text\">Informed consent (verbal or written) must be obtained and documented prior to the administration of RhIg.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L9<\/div>\r\n  <div class=\"lrisk-text\">For RhD negative pregnancies, determination of fetal RhD status by non-invasive prenatal testing (<em>cffDNA<\/em> testing of maternal plasma) is suggested to avoid unnecessary RhIg administration.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L10<\/div>\r\n  <div class=\"lrisk-text\">Routine antenatal RhIg at a dose of 300\u00a0\u03bcg (1500\u00a0IU), is recommended for all RhD negative pregnant individuals at approximately 28 weeks gestation.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L11<\/div>\r\n  <div class=\"lrisk-text\">\r\n    For sensitizing events in RhD negative pregnancies RhIg dosing varies depending on gestational age of the pregnancy:\r\n    <ul>\r\n      <li>less than 8 weeks 0 days: no RhIg required<\/li>\r\n      <li>> 8 \u2013 11 weeks: 120\u00a0\u03bcg (600\u00a0IU) for ectopic or molar pregnancies, trauma or invasive prenatal testing (RhIg not required for abortions)<\/li>\r\n      <li>> 12\u201319 weeks: 300\u00a0\u03bcg (1500\u00a0IU) for all sensitizing events<\/li>\r\n      <li>> 20 weeks: 300\u00a0\u03bcg (1500\u00a0IU) for all sensitizing events with FMH quantification to determine need for additional doses.<\/li>\r\n    <\/ul>\r\n  <\/div>\r\n\r\n  <div class=\"lrisk-code\">L12<\/div>\r\n  <div class=\"lrisk-text\">If immune anti-D is detected, RhIg is not recommended.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L13<\/div>\r\n  <div class=\"lrisk-text\">RhIg is recommended for routine prophylaxis and for sensitizing events in RhD negative pregnancies even when antibodies other than anti-D are present.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L14<\/div>\r\n  <div class=\"lrisk-text\">In the setting of ongoing or recurrent antepartum bleeding starting at 20 weeks (\u226520 weeks 0 days) gestation in an RhD negative pregnancy, both RhIg and FMH testing are recommended.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L15<\/div>\r\n  <div class=\"lrisk-text\">Following delivery of an RhD positive neonate in an RhD negative pregnancy, RhIg is required within 72 hours of delivery.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L16<\/div>\r\n  <div class=\"lrisk-text\">Postnatal RhIg dosing (300\u00a0\u03bcg (1500\u00a0IU) or 120\u00a0\u03bcg (600\u00a0IU)) may vary depending on access to FMH test results.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L17<\/div>\r\n  <div class=\"lrisk-text\">Quantitative FMH testing prior to 20 weeks gestation is not routinely recommended for RhIg dose guidance.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L18<\/div>\r\n  <div class=\"lrisk-text\">Quantitative FMH testing is required starting at 20 weeks (\u226520 weeks 0 days) gestation for pregnancies with a sensitizing event that may lead to FMH.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L19<\/div>\r\n  <div class=\"lrisk-text\">For sensitizing events starting at 20 weeks gestation (>20 weeks 0 days), RhIg doses should be based on quantitative FMH assessment with use of a validated calculator.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L20<\/div>\r\n  <div class=\"lrisk-text\">FMH testing is required postpartum for RhD negative pregnancies with an RhD positive neonate.<\/div>\r\n\r\n  <div class=\"lrisk-code\">L21<\/div>\r\n  <div class=\"lrisk-text\">Flow cytometry is recommended for confirmation of diagnosis and quantitation of FMH, where feasible.<\/div>\r\n<\/div>\r\n","link":"https:\/\/transfusionontario.org\/en\/category\/perinatal\/perinatal-low-risk-statements\/","name":"RhD, RhIg &amp; FMH Clinical Guidance","slug":"perinatal-low-risk-statements","taxonomy":"category","parent":448,"meta":[],"acf":[],"_links":{"self":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories\/453","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories"}],"about":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/taxonomies\/category"}],"up":[{"embeddable":true,"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/categories\/448"}],"wp:post_type":[{"href":"https:\/\/transfusionontario.org\/en\/wp-json\/wp\/v2\/posts?categories=453"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}