U.S. Preventive Services Task Force

Screening for Rh (D) Incompatibility

Release Date: February 2004

Summary of Recommendations / Supporting Documents

Summary of Recommendation

• The U.S. Preventive Services Task Force (USPSTF) strongly recommends Rh (D) blood typing and antibody testing for all pregnant women during their first visit for pregnancy-related care.

  Rating: A Recommendation.

  Rationale: The USPSTF found good evidence that Rh (D) blood typing, anti-Rh (D) antibody testing, and intervention with Rh (D) immunoglobulin, as appropriate, prevents maternal sensitization and improves outcomes for newborns. The benefits substantially outweigh any potential harms.

• The USPSTF recommends repeated Rh (D) antibody testing for all unsensitized Rh (D)-negative women at 24-28 weeks' gestation, unless the biological father is known to be Rh (D)-negative.

  Rating: B Recommendation.

  Rationale: The USPSTF found fair evidence that repeated antibody testing for unsensitized Rh (D)-negative women (unless the father is also known to be Rh [D]-negative) and intervention with Rh (D) immunoglobulin, as appropriate, provides additional benefit over a single test at the first prenatal visit in preventing maternal sensitization and improving outcomes for newborns. The benefits of repeated testing substantially outweigh any potential harms.

The USPSTF found no new evidence addressing the role of screening, new screening tests, new treatment protocols, or potential harms associated with screening and treatment of Rh (D) incompatibility. However, there is pre-existing good evidence for the efficacy and effectiveness of blood typing, anti-Rh (D) antibody screening, and postpartum Rh (D) immunoglobulin prophylaxis.

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Supporting Documents

Screening for Rh (D) Incompatibility, February 2004
Recommendation Statement
Brief Evidence Update

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