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We currently run a week D on our post postpartum OB patients RHoGAM evaluation  in addition to our Fetal Screen. This test is being questioned as unnecessary. I would like some opinions and alternate

suggestions why we should or should not do the Week D

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Just out of curiosity, does anyone remember why it was included in the first place?  At one time, long ago, the weak D test was thought to be useful in detecting fetal maternal bleeds but that is long past.

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22 hours ago, R1R2 said:

PERHAPS weak D was included because a positive weak D would alert you to a possible false positive fetal screen.  

That is what I always thought.  We dropped it when we went to our new computer system in August UNLESS the fetal screen comes up positive.  That hasn't happened yet.

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On ‎12‎/‎6‎/‎2018 at 10:16 AM, R1R2 said:

PERHAPS weak D was included because a positive weak D would alert you to a possible false positive fetal screen.  

It is a good reminder to generalists who can forget over the years that a strongly positive fetal screen with a negative Fetal stain is not a weird result (?!?) - it is probably just a weak D.  Without doing weak Ds regularly, it is easy to forget that as the years pass.  Doing the weak Ds as part of the RhIg workup is a different idea.  We just do them once on any Rh Neg and put it in the computer history.  I am trying to catch the young females and send them out for genotyping - nice to have a definitive answer that gives assurance of the right choices for individual pts.  So far, we have sent our genotyping to the UBS Reference Lab - which sends them on the Grifols Lab.  We get them back in about 2 weeks, so it goes in computer history for the next time we see the pt. 

Has anyone been using Immucor's Lab for RH genotyping?  How long do they take and how much do they charge?  (if anyone knows)

 

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