Reconsidering RhIg following threatened, spontaneous, or induced abortions in the first trimester.

Abstract

Routine Rh(D) immunoglobulin (RhIg) administration following first trimester threatened, spontaneous, or induced abortions is a long-standing practice, but emerging evidence suggests limited benefit. This editorial reviews the outdated data that has informed current guidelines and presents contemporary literature demonstrating a negligible risk of RhD alloimmunization at early gestational ages. Recent studies challenge the necessity of RhIg in the first trimester, and highlight the clinical, resource, and equity-related harms of routine use. In light of evolving evidence and the need to optimize healthcare delivery, we recommend against routine RhD testing and RhIg administration for first trimester threatened, spontaneous, or induced abortions.