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COVID-19: Anti D and Abortion

26 March 2020

Abortion is an essential healthcare service. During the COVID-19 pandemic, access to normal healthcare processes will be disrupted. Greater use of remote consultations, and early medical abortion at home, may be necessary to ensure women have access to timely and safe abortion care.

The RANZCOG Women’s Health Committee recommendation is to routinely give anti-D for first trimester miscarriage or abortion, regardless of medical or surgical management.

RCOG has released guidance on coronavirus (COVID-19) and abortion care. Testing for rhesus status and Anti D administration potentially adds delay and barriers to care. Based on the NICE guideline (2019) it is recommended that rhesus status determination and anti-D are not required for early medical abortion up to 10 weeks.

In the COVID-19 situation, RANZCOG advises that a clinician may appropriately decide not to administer anti-D prior to 10 weeks, for medical management of abortion, particularly when an additional visit may increase exposure of women and staff. For surgical management of abortion prior to 10 weeks, checking rhesus status, and aministration of anti-D, is discretionary, based on the individual woman’s risk benefit profile and her preferences.

Links

RCOG Coronavirus (COVID-19) infection and abortion care Information for healthcare professionals Version 1: March 2020

Abortion care NICE guideline [NG140]: September 2019

RANZCOG Guidelines for the use of Rh(D)Immunoglobulin (Anti D) in obstetrics C-Obs 6



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