Maternal D alloimmunization (prevention) Quiz: Ace Your Exams

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A 26-year-old primigravid woman presents to the emergency department with vaginal bleeding and cramping at 12 weeks of estimated gestational age (EGA). She has filled half of a maxi-pad over the past 4 hours and rates her cramping as a 5 on a 10-point scale. She has not had recent trauma or procedures. Past medical history is notable for mild anemia, and she takes prenatal vitamins and iron supplements. Temperature is 36.5°C (97.7°F), pulse is 86/min, respirations are 16/min, and blood pressure is 118/78 mmHg. On exam, the abdomen is non-tender to palpation. The cervix is closed, and a small amount of bright red blood is seen within the vaginal vault; however, no active bleeding is seen coming from the cervix. Bloodwork is obtained and shown below. A bedside ultrasound demonstrates a single viable intrauterine pregnancy with a fetal heart rate of 160/min. Based on the information provided, which of the following can be inferred?

 Laboratory Test Result Reference Range
 Hemoglobin 10.7 g/dL 12-16 g/dL    
 Hematocrit 31.4% 36-46%
 Leukocyte count 7,000 /mm3 4,500-11,000 /mm3
 Platelet count 175,000 /mm3 150,000-400,000 /mm3
 ABO blood group AB Not applicable
 Rhesus D factor Weakly positive Not applicable
 Antibody screen Negative Negative

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