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Poster Session 2

Category: Clinical Obstetrics

Poster Session 2

(669) Rh testing and immunoglobulin administration in early pregnancy among United States family planning providers

Wednesday, February 11, 2026

3:30 PM - 5:00 PM

Submitting Author and Presenting Author(s)

Shirley Qian, MD (she/her/hers)

Resident
Westchester Medical Center
White Plains, New York, United States

Coauthor(s)

AF

Ann Frisse, MD, MPH

Westchester Medical Center
Valhalla, New York, United States
JS

Jennifer Salcedo, MD, MPPA, MPH

Westchester Medical Center
Valhalla, New York, United States
TR

Timothy Ryntz, MD

Westchester Medical Center
Valhalla, New York, United States
BS

Bianca Stifani, MD, MPH

Westchester Medical Center
Valhalla, New York, United States

Objective:
New guidelines from some professional societies recommend foregoing routine Rh testing and Rh immunoglobulin (RhIg) administration for abortion or miscarriage before 12 weeks. We sought whether US Complex Family Planning (CFP) providers practice accordingly, and to describe the de-implementation process for routine Rh testing and RhIg administration.

Study Design:
Using the CFP e-mail listserv, we invited US CFP providers to complete an anonymous online survey hosted on Qualtrics. We offered a raffle for five 100 USD gift cards as a participation incentive. To examine predictors of following new guidelines, we conducted a relative risk regression using a modified Poisson approach with robust error variances, including covariates with p < 0.1 on bivariate analysis. We used Stata SE 16.1 for analyses, setting the level of significance at 5%.

Results:
Of 575 listserv members, 241 (41.9%) responded to the survey. Of these, 152 (63.1%) initiated Rh testing and 179 (74.3%) administered RhIg only after 12 weeks. Providers in the Midwest and West were more likely than those in the Northeast to follow new guidelines (RR 1.81 [1.23-2.66], and RR 2.25 [1.62-3.13], respectively). Those practicing at Planned Parenthood or independent clinics were more likely to follow new guidelines than those at academic medical centers (RR 1.39 [1.11-1.74]). Most respondents reported a deliberate effort to change practice at their facility (161/203, 79.3%). Some (78/203, 38.4%) reported disagreements among clinicians, but most said patients rarely (134/203, 66.0%) or never (35/203, 17.2%) disagreed.

Conclusion:
A large majority of participants de-implemented Rh testing or RhIg administration prior to 12 weeks gestation, aligning with the 2022 SFP guidelines. The two most influential factors were the practice region and the practice setting, perhaps most likely driven by state policies as described in the qualitative analysis of the study, in addition to expertise driven by maternal-fetal medicine specialists at those respective sites.