Passive Anti-D following RhIG Administration

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The page below is a sample from the LabCE course Hemolytic Disease of the Fetus and Newborn. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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Passive Anti-D following RhIG Administration

A scenario where anti-D is detected at delivery in a patient who received RhIG during pregnancy raises the question, is the anti-D active or passive?
Distinguishing between passive and immune anti-D is important clinically:
  • If passive anti-D is misinterpreted as active, RhIG prophylaxis may be omitted, leading to D sensitization.
  • If active anti-D is misinterpreted as passive, appropriate antibody investigation may be curtailed putting the fetus at risk of developing HDFN.
When this occurs, two main serologic questions need to be answered:
  1. Are the reactions due to passive anti-D from RhIG or due to active anti-D?
  2. Are there other antibodies that need to be excluded?