Yes ,the neutral cards do not contain any anti globulin reagents however I thought that if an Rh antibody was present this would be enhanced by the enzyme techniques? The current BCSH guidelines for compatibility testing state that is acceptable to exclude Rh antibodies using validated techniques with enzyme treated cells. That being said, if an antibody was detected by IAT showing Rh specificity I would not exclude its presence even if it was negative by enzyme technique.
In this case the reactions were variable but never more than a 2+ reaction, sometimes there in both techniques , and sometimes only by IAT. In the most recent sample, the enzyme is negative and the only reactions by IAT were with an R2R2 in the screening cells and with the R2R2 in the panel. (both 1+ reactions).
It is also possible that she has had a prophylactic anti-D injection that has not been documented in her notes. As far as management of the pregnancy is concerned anti-D prophylaxis will be recommended at present.