Our hospital has never given out the 50 dose for abortion/miscarriage <12 weeks. Our ER doctor wants to know why.

We only use the 300 dose. Not sure of the original reason for this since taking over, so don't know what to answer.

We only issue about 10-15 RhIG/month. 90% post partum, 10% for abortion/miscarriage or vaginally bleeding during pregnancy.

Could it be because we wouldn't use enough of the mini dose to stock it and it would outdate?

Any other valid reason for only using the 300 full dose?

Thanks,

Another common reason I have heard is to be sure there is not any sort of mix-up. Giving the 50 dose to a post partum by mistake could have huge fallout. We have always used the 300 dose on both antenatal and post partum situations.

I know my hospital discontinued using the mini dose for 3 reasons: 1. Cost-usually it isn't priced much less than the full dose. 2. It is better to have too much than not enough, many women have the due dates moved up after the first trimester. 3. OB 's mis-order the mini dose when a full dose should be used, the doctor then has to be tracked down for the order to be changed.

Agree with Deny and Kimster. We only give the 300 dose.

We also only use the 300 dose. Too much chance for error with the mini dose and not cost effective to stock because its actual use is limited to those extremely early miscarriages.

Any place I have ever worked we only used the full dose . . . the price was always the same as the minidose and, like everyone else, it is not worth using the incorrect product.

Our ER Docs want us to switch to the mini dose too, but fortunately our objections were not overruled. They said we were over-dosing 1st trimester patients. We countered by showing the cost is not much different between the two doses and the greatly increase possibility of a dosing error, ie. incorrectly using a 50 mcg dose on a post-partum or near term patient. We cited the Technical Manual which specifically discusses this possible error when both doses levels are available for issue and administration.