<abstract xmlns="http://www.w3.org/1999/xhtml"><p>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. <italic><bold>Immunohematology</bold></italic><bold>2016;32:108–111.</bold></p></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. Immunohematology2016;32:108–111.

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

Immunohematology

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–...

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

Article Category: Original Report

Published Online: Oct 09, 2019

Page range: 108 - 111

DOI: https://doi.org/10.21307/immunohematology-2019-055

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

© 2016 J.L. Hannon et al., published by Sciendo

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

Article Category: Original Report

Published Online: Oct 09, 2019

Page range: 108 - 111

DOI: https://doi.org/10.21307/immunohematology-2019-055

Keywordspregnancy, prenatal, laboratory testing, alloimmunization, anti-D, Rh immune globulin, anti-D prophylaxis, practice guidelines

© 2016 J.L. Hannon et al., published by Sciendo

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