RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Obstetrics & Gynaecology
Easy
In an Rh-negative pregnant woman, what injection should be given following delivery or miscarriage to minimize isoimmunization?
Appeared in: RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Explanation
- Rh Immune Globulin (also known as anti-D immunoglobulin) is administered to an unsensitized Rh-negative mother after potential exposure to Rh-positive fetal blood.
- It works by binding to and neutralizing any Rh-positive fetal red blood cells in the maternal circulation, preventing the mother from developing her own permanent antibodies.
- This prophylactic treatment protects future Rh-positive fetuses from hemolytic disease of the fetus and newborn (HDFN).
- The standard administration window is within 72 hours following a sensitizing event like delivery, miscarriage, or abortion.
Why Other Options Were Wrong
- Option A: Misoprostol is a prostaglandin analogue that causes uterine contractions.
- Option C: Ferrous Sulphate is an iron supplement.
- Option D: Magnesium Sulphate is a central nervous system depressant and smooth muscle relaxant.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of Rh isoimmunization in obstetrics as background academic context rather than a clinical decision trigger.
- A critical nursing responsibility is to verify the Rh status of both the mother and the newborn, and to confirm the mother's antibody screen (indirect Coombs' test) is negative before administering Rh Immune Globulin.
- Strict adherence to the 72-hour administration window post-delivery is crucial for ensuring the effectiveness of the prophylaxis.
- Patient education is vital. The nurse must explain to the mother that the injection is to protect future pregnancies, not her own health or the health of the just-delivered baby.
How to Approach the Question
- First, identify the key patient information: an Rh-negative pregnant woman.
- Next, understand the clinical problem: the risk of 'isoimmunization' after delivery or miscarriage. This means the mother's immune system might become sensitized to a foreign blood factor.
- Recall the specific blood factor incompatibility that is common in pregnancy: the Rh factor. An Rh-negative mother can be sensitized by an Rh-positive fetus.
- Think about the prophylactic treatment used to prevent this specific type of sensitization. The goal is to prevent the mother from making her own antibodies.
- Evaluate the options. Rh Immune Globulin is specifically designed for this purpose. The other medications (Misoprostol, Ferrous Sulphate, Magnesium Sulphate) are common in obstetrics but have completely different uses (uterine contraction, anemia, and seizure prevention, respectively).
Concept Tested & Keywords
- Concept Tested: Prevention of Rh isoimmunization in obstetrics.
- Stem keywords: Rh-negative, pregnant woman, delivery, miscarriage, isoimmunization
- Lead-in keywords: what injection
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
Qxh0UcqVnOxpx8_me-Hy3r
Reference Book
E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 467-469
E6 Obstetrics Williams pp. 48-68, 1-9
Practise the full RUHS, Jaipur, PB B.Sc Nursing Entrance-2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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