RhIG dose with pos FESC and neg K-B

[Mabel Adams]

We have had a policy to give 2 doses of RhIG if we get a pos Fetalscreen but find no fetal cells on the Kleihauer. I can't find any reference for why we started to do this before I came. Does anyone else do this? If so, do you know why?

This is more of an issue since there have been more apparent false positives with the Immucor Fetal screening test this past year.

[David Saikin]

It has always been the standard where ever I worked that you gave 1 more dose of RhIg than the KB indicated. If it indicates 1, we give 2.

[Lcsmrz]

The Fetal Screen is known to be a very sensitive screening test and somewhat subject to technique. We consider the K-B stain to be the gold standard in determining the extent of FMH and base our RhIg injecitons solely on it.

[John C. Staley]

In my recent past a positive screen resulted in a single dose of RhIG and a Flow Cytometry test for quantification. Any additional doses was based solely upon the flow results. I'm not sure how you would justify additional doses based simply on a positive screen. It was rare, about once per year, that the flow cytometry indicated an additional dose beyond the one we gave initially.

[Kimster]

This idea of adding one syringe came about because until recently most Rh Immune Globulins dose on their PI read as approximately 300mcg.. This idea was reinforced when several products had a recall for insufficient dosing. In some cases the amount of Anti-D in a syringe could be as low as 234mcg.

[quint]

1 is the standard