Reconsidering RhIg Following Threatened, Spontaneous, or Induced Abortions in the First Trimester

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 This editorial reviews the outdated data that have informed current guidelines and presents contemporary literature demonstrating a negligible risk of RhD alloimmunization at early gestational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 optimise health care delivery, we recommend against routine RhD testing and RhIg administration for first-trimester threatened, spontaneous, or induced abortions.