What is the USPSTF stance on the Rh(D) blood typing and antibody testing for pregnant women at their first prenatal visit?

• A. Strongly recommends Rh(D) blood typing and antibody testing for all pregnant women during their first visit.
• B. Recommends testing only for women with a history of Rh incompatibility.
• C. Advises against routine Rh(D) typing.
• D. No recommendation regarding Rh(D) typing and antibody testing.

Answer: (A)

Universal Rh(D) typing and antibody screening at the first prenatal visit is recommended because identifying a mother’s Rh status and checking for anti-D antibodies early allows prevention of hemolytic disease of the fetus and newborn. If a mother is Rh-negative and not already sensitized, timely Rh(D) immune globulin prophylaxis can be given to prevent future alloimmunization, and antibody results guide management for current and future pregnancies. Sensitization can occur even without a strong history of Rh incompatibility, so testing all pregnant individuals ensures cases aren’t missed. This approach improves pregnancy outcomes and is given an A recommendation because the net benefit is substantial. Other options fail because they miss cases, rely on history alone, or advise against routine typing, which contradicts the evidence.