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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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Initial Antibody Exclusions

Using the initial screen cell antigram below, we can see that the antibodies corresponding to the blue-highlighted antigens have been eliminated.


Screen Cell #3 is from a donor who is likely homozygous for c, e, Fya , Jkb, N, and S AND therefore excludes the corresponding antibodies. Anti-P1 and anti-Lea can be excluded by a single negative with an antigen positive red cell. In the antigram image on the right, all excluded cells are colored blue.
Therefore, possible (not excluded) antibodies include anti-C, D, E, K, Fyb, Jka, M, s, Leb.
Of these anti-Leb is not a cause of HDFN. Leb is poorly developed on fetal RBCs and the antibodies are not considered to be significant when identified in maternal serum.