This course is about a common scenario in the transfusion service (TS) laboratory, the detection of anti-D at delivery in a female who has received Rh immune globulin (RhIg) during pregnancy. A case study is presented that will:

• Guide participants through laboratory findings that need to be interpreted and resolved;
• Examine current best practices in perinatal testing programs;
• Review the characteristics of RhIg and its use in pregnancy;
• Review and investigate key issues associated with detection of anti-D in women who have received antenatal RhIg;
• Discuss crossmatch and LIS policies related to RhIg-derived passive anti-D.

This case study presents an opportunity to review perinatal testing programs and the crucial role of RhIg in preventing hemolytic disease of the fetus and newborn (HDFN) due to anti-D. The case also examines practical aspects of routine serologic testing involving neonates and women who have received RhIg during pregnancy. 

Intended Audience: This program is designed as an educational and training tool for Clinical laboratory technologists and technicians. This course is also appropriate for clinical laboratory science students and pathology residents.

Learning Objectives

• Discuss the history of RhIg, its sources, preparation, constituents, safety, types, mechanisms of action, criteria for the administration of RhIg antenatally and postnatally, dosage calculation, and causes of failures.
• Interpret serologic tests done on the mother, father, and fetus / newborn as part of perinatal testing programs, including antibody identification.
• Identify best practices for serologic and other tests used in perinatal testing programs.
• Describe the principles, uses, and limitations of the rosette test, Kleihauer-Betke test, and flow cytometry in Rh prevention programs.
• Discuss and resolve key issues associated with detection of anti-D in women who have received antenatal RhIg.
• Identify crossmatch and LIS policies and practices related to RhIg-derived passive anti-D.

This course has been approved for P.A.C.E.® credit. There are no prerequisites for this course.