A 14-week Rh-negative pregnant woman presents with mild vaginal bleeding and abdominal pain. Ultrasound shows a viable intrauterine pregnancy. Her husband is Rh-positive. What dose of Anti-D immunoglobulin should be administered According to ACOG guidelines ?

1. A

   300 mcg

2. B

   75 mcg

3. C

   100 mcg

4. D

   150 mcg

Appeared in: NORCET-7 Mains

Explanation

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• according to ACOG guidelines till 12 weeks gestation, the recommended Anti-D dose is 150mcg.
• 300 mcg is an appropriate and guideline-supported dose for threatened miscarriage at after 12 weeks.
• Higher doses are reserved for later gestation or larger fetomaternal hemorrhage.
• According FOGSI dose before 20 week is 150mcg after 20 week is 300mcq

Why Other Options Were Wrong

• Option B: 75 mcg is not standard dose for events .
• Option C: 100 mcg is not a standard dose for this gestational age or event.
• Option D: 150 mcg is not a standard dose for threatened miscarriage at 14 weeks.

Related Visual

Clinical Relevance

• Nursing practice connection: Use the key finding related to Anti-D immunoglobulin dosing for Rh-negative pregnant women with sensitizing events in early pregnancy to guide bedside assessment, documentation, and the next nursing action.
• Nurses must ensure timely administration of Anti-D to prevent Rh sensitization and future hemolytic disease of the newborn.
• What if? If the event occurred after 12 weeks, a 300 mcg dose would be required, and a Kleihauer-Betke test may be needed to estimate fetomaternal hemorrhage volume.

How to Approach the Question

• Identify the gestational age and type of event (threatened miscarriage at 14 weeks).
• Recall the recommended Anti-D dose for 12 weeks gestation.
• Eliminate options that are too high (postpartum/third trimester) or not standard.
• Choose the dose that matches guideline recommendations for the scenario.

Concept Tested & Keywords

• Concept Tested: Anti-D immunoglobulin dosing for Rh-negative pregnant women with sensitizing events in early pregnancy
• Stem keywords: 14-week pregnant woman, Rh-negative, vaginal bleeding, abdominal pain, viable intrauterine pregnancy, husband Rh-positive, Anti-D immunoglobulin dose
• Lead-in keywords: should be administered
• Clinical cues: 14 weeks gestation
• Clinical cues: threatened miscarriage

Question ID

Q_VesBDQQNeEcwombdXvCh

Copy ID

Reference Book

E6 Obstetrics Williams pp. 48-68, 1-9