In which scenario is the administration of anti-D immune globulin indicated?

Administration of anti-D immune globulin is indicated in the scenario where an Rh D-negative patient presents with vaginal bleeding early in pregnancy, particularly at 13 weeks of gestation. The purpose of administering anti-D immune globulin in this context is to prevent Rh incompatibility complications. If an Rh D-negative woman is exposed to Rh-positive blood (which can occur during bleeding), her immune system may produce antibodies against the Rh D antigen, which could affect future pregnancies by leading to hemolytic disease in the newborn.

In early pregnancy, the risk of fetal-maternal hemorrhage is heightened with vaginal bleeding, as it can signify placental issues or other complications that may lead to fetal blood cells entering the maternal circulation. By administering anti-D immune globulin, the potential sensitization of the mother to Rh-positive blood is mitigated.

The other scenarios do not warrant the administration of anti-D immune globulin, as either the patient is Rh D-positive and therefore does not require the immune globulin, or the timing of the situation does not indicate a risk for Rh sensitization that would necessitate treatment with the immune globulin.