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The page below is a sample from the LabCE course Rh-Negative Female with Anti-D at Delivery: A Case Study. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Case Presentation

Patient A.D., a 30 year old female, was admitted to the hospital in active labor to deliver at 37 weeks gestation. Transfusion service (TS) records showed A.D. to be group O Rh negative with no record of unexpected red cell antibodies.
Maternal history showed two prior pregnancies. Her first pregnancy, four years ago, ended in spontaneous abortion at 9 weeks gestation and she received a mini-dose (50 µg) of RhIG.
In the second pregnancy, two years ago, the infant typed as Group A Rh positive, DAT negative. Patient A.D. was injected with RhIG within 72 hours of delivery.
The laboratory also confirmed that in the current pregnancy RhIG was administered at approximately 28 weeks gestation subsequent to a negative antibody screen.

After many hours of non-productive labor, the physician considered that labor had stalled and decided to do a cesarian section (C-section). According to hospital policy for C-sections, a type and screen was ordered.