Maternal D alloimmunization (management) Quiz: Ace Your Exams
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A 28-year-old woman, gravida 3, para 0020, at 18 weeks estimated gestational age (EGA), presents for a routine antenatal appointment. Her partner who fathered this pregnancy has an A-positive blood type, while her blood type is O-negative. She had some light vaginal bleeding 4 weeks ago, and an ultrasound in the emergency department (ED) showed a strong fetal heartbeat at the time. She was given an injection, and her bleeding resolved after a few days. She has not had any complications since that time. Her obstetrical history is notable for an ectopic pregnancy treated “with several different types of shots,” followed by a miscarriage at 6 weeks EGA which was diagnosed by an ultrasound showing only a yolk sac without development of a fetal pole. Her miscarriage was treated with “pills only, no shots.” Today, her vital signs are within normal limits, and a physical exam is unremarkable. A type and screen show maternal Rh antibodies are present. Which of the following is the most likely explanation for this finding?
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