Rh-Negative Female with Anti-D at Delivery: A Case Study (by LabCE)

2 P.A.C.E. contact hour(s)

(based on 651 customer ratings)

Author: Pat Letendre, M. Ed.
Reviewer: Erin Tretter, MT(ASCP) and Rory Huschka, M.Ed., MT(ASCP)

Course provided by LabCE.

If you have completed the course, Hemolytic Disease of the Fetus and Newborn, you will enjoy working through a case that provides real-world application of what you have learned.

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.

You will be guided through laboratory findings that need to be interpreted and resolved; be presented with 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; and learn about crossmatch and LIS policies related to RhIg-derived passive anti-D.

See more courses in: Blood Banking / Immunohematology

Included In These Course Packages

Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Course number 578-014-22, approved through 2/28/2024
Florida Board of Clinical Laboratory Personnel Credit Hours - General (Blood Banking / Immunohematology): 2 hour(s)
Course number 20-896606, approved through 2/28/2024


  • 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.

Customer Ratings

(based on 651 customer ratings)

Course Outline

  • Case Scenario
      • Introduction
      • Case Presentation
    • Initial Serologic Test Results
      • ABO, Rh, and Antibody Screen
      • Antigram to Explain Prior Question
  • Perinatal Testing Programs
      • Perinatal Testing Programs
      • Immunogenicity
      • Routine Serologic Tests: Mother
      • Routine Serologic Tests: Newborn Protocols
      • Routine Serologic Tests: Newborn Protocols, continued
  • Interpreting Initial Serologic Tests
      • Interpreting Initial Serologic Tests
      • Antibody Exclusion Protocol (General)
      • Initial Antibody Exclusions
      • Antibody Exclusion Protocols (RhIG)
      • Passive or Active Immunization?
      • RhIG-Derived Anti-D Reaction Strength
      • Factors Affecting RhIg Reaction Strength
      • How Long Can RhIG Be Detected?
  • Follow-up Serologic Tests
      • How Much Testing?
      • Mini-Panel Antibody Exclusion
  • Post-delivery Testing
      • Serologic Tests on Newborn
      • Newborn's Clinical Status
      • Screening for Fetomaternal Hemorrhage (FMH)
      • Quantifying FMH
      • Kleihauer-Betke (KB) Test
      • Flow Cytometry
      • Calculating RhIG Dosage
      • Assessing FMH and RhIG Dosage
  • Summary and Conclusions
      • Case Summary
  • When Transfusion Is Necessary
      • Crossmatch Issues
      • Crossmatch Implications of RhIg-associated Passive Anti-D
      • Crossmatch Practices Related to RhIG - Introduction
      • LIS Issues Related to RhIG
      • Crossmatch Practices Related to RhIG: Examples
  • Further Reading
      • Further Reading
  • References
      • References

Additional Information

Level of instruction: Intermediate

Intended Audience: Clinical laboratory technologists, technicians, and pathologists. This course is also appropriate for clinical laboratory science students and pathology residents.
Author information: Pat Letendre, MEd is a laboratory technologist, educator, and consultant. Currently, she consults full-time in the areas of transfusion medicine, education, professional development, and use of the Internet in education. Ms. Letendre is the Webmaster for Canada's transfusion safety officers and the TraQ website coordinator. She holds a Masters of Education degree in adult education from the University of Alberta and a Bachelor of Science degree from the University of Manitoba.  
Reviewer information: Erin Tretter, MT(ASCP), is currently the STAT Laboratory Supervisor at Penn Presbyterian Medical Center in Philadelphia, PA. She received her BS in Medical Technology from California University of Pennsylvania and has nearly 8 years of experience as a Generalist, including Blood Bank, Hematology and Chemistry. Erin is the Blood Bank Clinical Instructor for the Clinical Laboratory Science Program at St. Christopher’s and has 4 years experience teaching immunohematology concepts and laboratory procedures to Medical Technology students. She has also provided blood bank training for laboratory technologists and medical students. Erin is currently obtaining a Master’s in Business Administration from Florida Institute of Technology where she is a member of the Phi Kappa Phi Honor’s Society.
Rory Huschka, M. Ed., MT(ASCP), has over 20 years of combined experience as a medical technologist, technical supervisor, professor, and manager. He is the former Director of Clinical Laboratory Science and Medical Laboratory Technician Programs at Brookline College. He is currently a Program Director at MediaLab, Inc. Rory holds a BS degree in Medical Technology from North Dakota State University and a Masters in Educational Leadership.  

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