post partum rhogam work-up

[jhoannac]

are antibody screens always required as part of a post partum rhogam work-up? what if the mom got their rhogam dose way past their 28 wk due? it's going to be positive for anti-D for sure, right?

[Lcsmrz]

We perform an antibody screen as part of a post-partum RhIg workup, unless a T&S was performed in the same admission. If positive -- and it usually is -- we use the "R Set" to check for antibodies other than passive Anti-D.

We found an Anti-Kell once, and the baby was Kell negative -- go figure!

[Franklyn]

We do the same at my facility. We confirm that the only antibody present is anti-D, and allow the physician to presume that it is due to the administration of RhIg.

While we haven't found any extra antibodies that I am aware of, we have uncovered several cases of patients "sharing" their insurance card which produced a history of multiple blood types and ABOs - so we always perform the ABO/Rh and Antibody screen to be certain.

[David Saikin]

An antibody screen is not required by Standards post-partum.

[John C. Staley]

If we have a record of a negative antibody screen during the current pregnancy we do NOT repeat the antibody screen for a post partum RhIG. This way we don't have to waste time, effort and $$$$ identifying passive anti-D due to the antenatal RhIG injection.

[Mabel Adams]

Our OB dept. was getting annoyed with the delay of identifying the anti-D in pos postnatal screens. Plus it was more costly. Besides the same action was going to be taken (give RhIG) regardless of the result fo the screen. If some other antibody was going to be found, the baby would probably have a pos DAT causing a workup that ID'd it. If not, the mom probably wasn't going to decide about getting pregnant again, based on the fact that she has an anti-K. It would be dealt with in the next pregnancy, if there is one.