The case presented highlights the risk of fetomaternal haemorrhage in ectopic pregnancy. With the current shortages of anti-D, it may be necessary to reduce administration of anti-D, but this may result in an increase in rhesus isoimmunization. As Kleihauer testing may be of limited value (1), recommendations by deCrespigny and Davison (2) for the use of a reduced dose of 30 mcg anti-D in all rhesus negative women with early pregnancy complications including ectopic pregnancy, would seem appropriate.