What is the best way to prevent isoimmunization in an Rh-negative patient with frequent first trimester spotting?
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Pregnant patients who are Rh negative should be given Rh immunoglobulin (RhIg) in the first trimester if they have heavy or repeated episodes of vaginal bleeding. RhIg is not indicated for uncomplicated miscarriage or for a single episode of mild vaginal bleeding. (SOR C, based on expert opinion and small clinical trials.)
Evidence Based Practice 12(6): 09.