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(Online CE Course)

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Continuing Education Credits

P.A.C.E.® Contact Hours (acceptable for AMT, ASCP, and state recertification): 2 hour(s)
Course number 578-032-20, approved through 4/30/2022
Florida Board of Clinical Laboratory Personnel Credit Hours - General (Blood Banking / Immunohematology): 2 hour(s)
Course number 20-696571, approved through 9/1/2020


  • Describe and interpret typical clinical symptoms and associated laboratory test results in hemolytic disease of the fetus and newborn (HDFN) and relate findings to the pathogenesis of HDFN and its treatment.
  • Describe the progression of HDFN due to anti-D historically and discuss the effect of Rh immune globulin (RhIG) and other factors on its incidence.
  • Compare and contrast ABO HDFN and HDFN due to anti-D and other antibodies in terms of clinical symptoms, fetal monitoring procedures, laboratory investigation, typical test results, and criteria for donor RBC transfusions.
  • Identify current best practices for perinatal testing programs and investigation of HDFN and interpret serologic tests done on the mother, father, and fetus / newborn.
  • Discuss the criteria for administration, dosage calculation, and causes of failures of RhIG.
  • Describe the principles, uses, and limitations of the rosette test, Kleihauer-Betke test, and flow cytometry used in perinatal testing programs.

Course Outline

Click on the links below to preview selected pages from this course.
  • Pathophysiology of HDFN and Blood group systems most commonly implicated in the disease
      • Introduction
      • Development of Anti-D
      • Factors That Affect Production of Anti-D
      • Primary versus Secondary Response
      • Pathophysiology in Severe HDFN Due to Anti-D
      • HDFN Due to Anti-D
      • ABO HDFN
      • ABO HDFN: Diagnostic Tests
      • ABO HDFN: Expected Findings
      • ABO HDFN: Treatment
      • ABO incompatibility between a D-negative mother and a D-positive fetus eliminates the possibility of HDFN due to anti-D.
      • HDFN Due to Other Antibodies
      • Phototherapy helps to prevent which symptom of HDFN?
      • For which of the following antibodies is the DAT most likely to be negative when testing a newborn for possible HDFN?
      • Kernicterus due to high levels of unconjugated bilirubin can cause brain damage in newborns suffering from severe HDFN.
  • Fetal Monitoring and HDFN Treatments
      • Fetal Monitoring
      • Prenatal Treatment
      • Choosing Donor RBC for IUT and IVT
      • Postnatal Treatment: Exchange Transfusion
      • Criteria for Transfused Red Blood Cells
      • Other Postnatal Treatment
      • All of the following criteria for donor RBC to be used for an exchange transfusion relate to both ABO HDFN and HDFN due to anti-D:Less than or equal t...
      • Which procedure used to obtain a fetal blood sample to monitor severity of HDFN can also be used to deliver intravenous transfusions?
  • Perinatal Testing Programs
  • Review of Rh Immune Globulin
      • RhIG Prophylaxis
      • RhIG Uses
      • RhIG and Variants of D
      • RhIG Policies for Weak D
      • Clinical Relevance of D Phenotypes
      • RhIG 'Failures'
      • Passive Anti-D following RhIG Administration
      • Protocols to Deal with RhIG-Derived Anti-D
      • When given during pregnancy, RhIG may cross the placenta and sensitize fetal D-positive RBCs.
      • Ectopic pregnancy is an indication for administering RhIG to an Rh negative woman.
      • A Rh positive individual has produced an anti-D antibody. Which D variant possesses the ability to stimulate this production of anti-D? (Choose all th...
      • What dose of RhIG can suppress immunization of 30 mL of D-positive whole blood?
  • Post-delivery Testing of RhIG Candidates
      • Introduction
      • Screening for Fetomaternal Hemorrhage (FMH)
      • Rosette Test
      • Quantifying FMH
      • Kleihauer-Betke (KB) Test
      • Flow Cytometry
      • Calculating RhIG Dosage
      • Which of the following tests are suitable for quantifying the size of fetomaternal hemorrhage (FMH)? Select all that apply.
      • A rosette test may be FALSELY POSITIVE if the mother is weak-D positive.
      • The appropriate dosage of Rh immune globulin (RhIG) to administer post-delivery to an Rh-negative mother delivering an Rh-positive child is calculated...
  • Summary and Conclusions
  • Further Reading
      • Resources
  • References
      • References
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