Injection Anti-D should be given following birth of Rh+ve fetus to Rh -ve mother within stipulated time limit… - NIA - 29 January 2023

NIA - 29 January 2023

Obstetrics & Gynaecology

Easy

Appeared in: NIA - 29 January 2023

Explanation

The standard clinical protocol is to administer Anti-D immune globulin (RhIg) within 72 hours of delivery to an unsensitized Rh-negative mother who has given birth to an Rh-positive infant.
This timeframe is crucial because it allows the injected antibodies to neutralize any Rh-positive fetal red blood cells in the maternal circulation before the mother's immune system can recognize them and produce its own antibodies.
Preventing this primary immune response (sensitization) is essential to protect future Rh-positive fetuses from developing Hemolytic Disease of the Fetus and Newborn (HDFN).

Option A: While administering the injection within 12 hours is effective, it is not the stipulated upper limit. The protocol allows for a longer window.
Option B: Similar to the 12-hour option, administration at 24 hours is acceptable, but it does not represent the maximum time allowed by the guidelines.
Option D: Administration at 48 hours is also well within the effective period, but the established protocol provides a 72-hour window.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain This question tests the knowledge of the standard protocol for preventing Rh isoimmunization in an Rh-negative mother after the birth of an Rh-positive child as background academic context rather than a clinical decision trigger.
Administering Anti-D immunoglobulin is a cornerstone of modern obstetric care to prevent Hemolytic Disease of the Fetus and Newborn (HDFN), a potentially fatal condition for the fetus/newborn in subsequent pregnancies.
Nurses play a critical role in this process. Responsibilities include verifying maternal and infant blood types, confirming the absence of prior sensitization, ensuring the order is correct, administering the injection within the 72-hour window, and accurately documenting the procedure.
What if the 72-hour window is missed? The injection should still be given as soon as the omission is discovered. Some protection may be offered for up to 28 days postpartum, although the efficacy is reduced the longer the delay.

How to Approach the Question

First, identify the core of the question: the correct timing for postpartum Anti-D injection.
Recognize the specific clinical scenario presented: an Rh-negative mother and an Rh-positive fetus, which is the indication for the injection.
Understand that this is a factual recall question based on a critical safety protocol in obstetrics.
Recall the standard window of administration for Anti-D immunoglobulin to prevent Rh sensitization.
Differentiate between an acceptable time for administration (e.g., 12, 24, or 48 hours) and the maximum time limit allowed by the protocol. The question specifically asks for the 'stipulated time limit'.
Select the option that matches the established international guideline, which is 72 hours.

Concept Tested & Keywords

Concept Tested: This question tests the knowledge of the standard protocol for preventing Rh isoimmunization in an Rh-negative mother after the birth of an Rh-positive child.
Stem keywords: Injection Anti-D, Rh+ve fetus, Rh -ve mother, birth, time limit
Lead-in keywords: stipulated time limit

QFbCY5Hs8MP3Pz6ctesYqn

E6 Pathology- ROBBINS & COTRAN PATHOLOGIC BASIS OF DISEASE 10TH Ed p. 467-469

E6 Obstetrics Williams p. 48-68