Laboratory management of perinatal patients with apparently “new” anti-D

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Immunohematology

American National Red Cross

Subject: Medical Laboratory Technology

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ISSN: 0894-203X
eISSN: 1930-3955

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VOLUME 32 , ISSUE 3 (September 2016) > List of articles

Laboratory management of perinatal patients with apparently “new” anti-D

Judith L. Hannon * / Gwen Clarke

Keywords : pregnancy, prenatal, laboratory testing, alloimmunization, anti-D, Rh immune globulin, anti-D prophylaxis, practice guidelines

Citation Information : Immunohematology. Volume 32, Issue 3, Pages 108-111, DOI: https://doi.org/10.21307/immunohematology-2019-055

License : (Transfer of Copyright)

Published Online: 09-October-2019

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ABSTRACT

Despite the existence of long-standing, well-organized programs for Rh immune globulin (RhIG) prophylaxis, immune anti-D continues to be detected in the D– perinatal population. Between 2006 and 2008, 91 prenatal patients, found to have a previously unidentified anti-D, were followed up with a survey to their treating physician and with additional serologic testing where possible. The physician survey requested pregnancy and RhIG history information, including recent or distant potential alloimmunizing events, and the physicians were asked their opinion on the likely cause for the anti-D. Based on survey responses, updated RhIG information, and results of follow-up serology, anti-D was determined to be attributable  to previously unreported RhIG in 44 of 91 (48.3%) cases and to active immunization (immune anti-D) in 36 of 91 cases (39.6%). A probable cause for alloimmunization was reported in 14 of 52 (26.9%) returned surveys. Anti-D alloimmunization continues to occur in our prenatal population despite a comprehensive approach to RhIG therapy. Observations from this prospective patient management strategy include the need for improved application of guidelines for RhIG administration and improved quality of information provided to laboratories assessing RhIG eligibility. A laboratory process for prospective follow-up when unexpected anti-D is detected in pregnancy is recommended.

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REFERENCES

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