Rho immune globulin will be ordered after birth if which situation occurs?
Mother Rh-, baby Rh+
Mother Rh+, baby Rh-
Mother Rh+, baby Rh+
Mother Rh-, baby Rh-
The Correct Answer is A
A. Rho(D) immune globulin (RhoGAM) is indicated when an Rh-negative mother gives birth to an Rh-positive infant. This prevents the mother’s immune system from developing antibodies against Rh-positive blood cells, which could cause hemolytic disease of the newborn (HDN) in future pregnancies.
B. An Rh-positive mother already has the D antigen, so she will not form antibodies against an Rh-negative baby. RhoGAM is not needed.
C. The mother is Rh-positive and cannot develop antibodies against Rh-positive fetal blood cells. No RhoGAM is required.
D. Both mother and baby are Rh-negative, so there is no risk of maternal sensitization. RhoGAM is not indicated.
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Related Questions
Correct Answer is C
Explanation
A. A threatened miscarriage is characterized by vaginal bleeding, mild cramping, and a closed cervix, but the fetus is still viable with a detectable heartbeat. In this case, the fetal heartbeat is absent, making a threatened miscarriage unlikely.
B. An incomplete miscarriage occurs when some products of conception have been expelled while others remain in the uterus. It is usually accompanied by heavy bleeding, cramping, and an open cervix. This client has a closed cervix and no bleeding, ruling out an incomplete miscarriage.
C. A missed miscarriage occurs when the fetus has died in utero but has not been expelled. The client may have no symptoms—no bleeding or cramping—and the cervix remains closed. Ultrasound confirms the absence of fetal cardiac activity, which matches this presentation. Missed miscarriages often require medical or surgical management to prevent complications such as infection or coagulopathy.
D. An inevitable miscarriage is indicated by vaginal bleeding, cramping, and cervical dilation, suggesting that miscarriage is in progress and cannot be prevented. Since this client has a closed cervix and no active bleeding, an inevitable miscarriage is unlikely.
Correct Answer is B
Explanation
A. Hypoglycemia in newborns is generally caused by maternal diabetes, preterm birth, intrauterine growth restriction, or perinatal stress. It occurs because the newborn produces excess insulin or has limited glycogen stores. Rh sensitization does not affect glucose metabolism, so neonatal hypoglycemia is unrelated to maternal Rh status.
B. If an Rh-negative mother becomes sensitized after delivering an Rh-positive infant without receiving Rho(D) immune globulin, she can form anti-Rh antibodies. In a future pregnancy with an Rh-positive fetus, these antibodies can cross the placenta and destroy fetal red blood cells, causing hemolytic disease of the newborn (HDN). Severe HDN may lead to fetal anemia, hydrops fetalis, or miscarriage/stillbirth if left untreated.
C. Macrosomia, defined as birth weight >4,000–4,500 g, is typically associated with maternal diabetes, maternal obesity, or genetic predisposition. Rh incompatibility does not influence fetal growth or increase the risk of macrosomia, so it is not a concern in sensitized mothers.
D. Placenta previa occurs when the placenta partially or completely covers the cervical os, which can cause bleeding during pregnancy. Its risk factors include previous cesarean delivery, uterine surgery, multiple gestations, or advanced maternal age, but Rh sensitization has no effect on placental location, so it is unrelated.
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