Rh Incompatibility Treatment & Management

Updated: Mar 15, 2017
  • Author: Leon Salem, MD, MS; Chief Editor: Bruce M Lo, MD, MBA, CPE, RDMS, FACEP, FAAEM, FACHE  more...
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Prehospital Care

When possible, prehospital care personnel should direct their efforts on stabilization of the mother and infant, followed by immediate transport to a facility specializing in high-risk obstetric and neonatal care.


Emergency Department Care

ED care of the pregnant woman with Rh-negative blood and a suspected fetomaternal hemorrhage varies depending on the presentation of the patient and the gestational age of the fetus.

If the mother has Rh-negative blood and has not been sensitized previously, administer human anti-D immune globulin (Rh IgG or RhoGAM) and refer the woman for further evaluation.

If the mother has been sensitized previously, as determined by elevated level of maternal Rh antibodies, administration of Rh IgG is of no value. In this situation, prompt referral to a center that specializes in high-risk obstetrics is warranted.

When an infant with Rh incompatibility is delivered in the ED, a more aggressive approach is required, centering on respiratory and hemodynamic stabilization of the infant and determining the need for an emergent exchange transfusion and phototherapy.

Stress the importance of early prenatal care to each pregnant female who presents to the ED. Early administration of Rh IgG in conjunction with early prenatal care is the best means to prevent Rh incompatibility

Referrals and consultations

After administering Rh IgG in the ED, promptly refer the Rh-negative pregnant mother of an Rh-positive fetus to an institution equipped for high-risk obstetric care.

Refer every pregnant female with Rh incompatibility to a medical center specializing in high-risk obstetric care.