Weak D - Patient not prescribed RhIG

[pricklecushion]

I would like to know how to handle a case where a patient never received RhIG who is Weak D positive and 32 weeks pregnant with her second child. First child is A+

What further testing would be recommended?

Thanks! -p

[Malcolm Needs ☆]

I would like to know how to handle a case where a patient never received RhIG who is Weak D positive and 32 weeks pregnant with her second child. First child is A+

What further testing would be recommended?

Thanks! -p

As no anti-D was produced by this patient after her first pregnancy, and none has been detected during this present pregnancy, I would not worry at all.

Nothing other than routine testing is required, and the patient does not require RhIG.

[David Saikin]

Depends on what your policy for Weak D pts is . . . We have not performed Weak D testing on ob's for years. At my institution, she would be a candidate for RhIg.

[AMcCord]

Same at ours, in accordance with AABB recommendations for prenatal/OB testing.

Edited July 11, 2011 by AMcCord

[ElinF]

We do prenatal ABORH testing in Gel so most of our Weak D patients come out as 3+ positive. She would not be a canidate for Rhogam and as long as her AB screen ins negative we wouldn't do any other work on her.

[pricklecushion]

For those that say they never do weak d testing... what if the patient was already classified as weak d from another lab/institution and had the above scenario? One RH+ pregnancy, never received RhIG, with no anti-d at beg of second pregnancy. Would she still be a candidate for RhIG? Seems like this case would be an exception to the rule, no?

[David Saikin]

If she typed as negative with anti-D we'd give her RhIg. Most WeakD+ come up in gel so we would consider her Rh+ at that point. With tube testing that is not always the case. We discussed that scenario with our OB docs prior to cessation of weak D testing so they would be aware of the possibilities.