Do you require a current Rh typing in order to issue RhIg?

Does anyone require abid if it is known antenatal rhogam was recently given for post-partum rhogam?

We do the mini panel using Ortho gel that is usually 3-5 cells on the Resolve panel A. This rules out everything but anti-D

We require a Type and Screen to give RhiG and if the screen is positive we are required to due a full panel.

We define "current" as during this pregnancy and we want at least 2 with one during this this pregnancy.

If the post parnum ab screen is positive, and the patient has already received rhogam, and the pattern is consistent with rhogam, we call the Doctor to see if they want the antibody identified.

If the patient has a history of receiving RhIg recently then we run a mini panel. This mini panel will rule out all other antibodies using one homozygous cell. (Except E, C and K are usually ruled out using a heterozygous cell.) If it fits the pattern of anti-D then we report it as "passive D due to RhIg".

Just as long as there are 2 concordant blood types, it is not necessary to retype. Refer to AABB Transfusion journal vol., 30, no 2-1990 page 180-181 for a committee report

At our hospital facility we do not require Rh type to be performed prior to patient receiving RhIG therapy antenatal in an outpatient setting, but we do for patients that are admitted - It's part of CAP requirement TRM.40785.

We have many doctor's office accounts for prenatal workups and it's up to the doctor to determine the Rh status of the patient. Then they sent the pt to our outpatient lab to recieve RhIg. Truly a transfusion service cannot "require" anymore testing than what the doctor orders. So if their order is for Rh immunoglobulin therapy - that's all they get - even if our facility has no Rh type on them. (I will say that 90% of the time we have a past history or a type and screen is ordered concurrent with the order for RhIG therapy).

As far as standards go AABB Transfusion Journal vol 41,2001 committee report update from the 1990 SSCC report has recommended guidelines for prenatal testing in which First and subsequent prenancies should have ABORh and screen (with ABID workup for pos screen) tested on initial visit, and all D neg pregnancy should have testing before RhIg therapy.

FYI - they also recommend that only when Rh is clearly positive (>/=2+) should the woman be considered D+. Thought that was interesting.

We do the same as MeganPLT for RhIg issue.

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