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Exercise 12.3 B.W. was seen by her OB-GYN at 10 weeks of gestation with her first pregnancy. Results of her prenatal workup indicate she is group O, D-negative with a negative antibody screen. Repeat testing at 28 weeks continues to indicate a negative antibody screen, and she is given 300 ?g of RhIG. The pregnancy proceeds normally, and she delivers a 7 lb 2 oz boy at 39 weeks of gestation. Results of cord blood tests are as follows: | Anti-A | Anti-B | Anti-D | Weak D | Weak D control | DAT | Mother's Sample Screen cells | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | 3+ | 0 | 0 | 1+ | 1+ | 1+ | Weak positive | Infant hemoglobin is 17.3 g/dL, and bilirubin is 0.6 mg/dL. 1. Does this infant have HDFN? If so, what is the most probable cause? 2. What could be causing the positive screen result? How would you confirm? Exercise 12.3 Additional Testing An elution is performed. The eluate is tested against A?, B, and O reagent red cells, incubated at 37° C, and tested at the AHG phase: | | A? | B | O | | :--- | :--- | :--- | :--- | | Eluate | 1+ | 1+ | Negative | 3. What do these results indicate? 4. What type of treatment would be recommended for this infant? 5. Is B.W. a candidate for postpartum RhIG? If so, are any additional tests necessary? Exercise 12.3 Additional Testing A fetal screen performed on B.W. yields a positive result. 6. What test needs to be performed and why? Exercise 12.3 Additional Testing A Kleihauer–Betke stain is performed on B.W.'s postpartum specimen to quantify the amount of FMH. There were 19 fetal cells counted in a total of 2000 cells. 7. How many doses of RhIG should B.W. receive?

          Exercise 12.3
B.W. was seen by her OB-GYN at 10 weeks of gestation with her first pregnancy. Results of her prenatal workup indicate she is group O, D-negative with a negative antibody screen. Repeat testing at 28 weeks continues to indicate a negative antibody screen, and she is given 300 ?g of RhIG. The pregnancy proceeds normally, and she delivers a 7 lb 2 oz boy at 39 weeks of gestation. Results of cord blood tests are as follows:

| Anti-A | Anti-B | Anti-D | Weak D | Weak D control | DAT | Mother's Sample Screen cells |
| :--- | :--- | :--- | :--- | :--- | :--- | :--- |
| 3+ | 0 | 0 | 1+ | 1+ | 1+ | Weak positive |

Infant hemoglobin is 17.3 g/dL, and bilirubin is 0.6 mg/dL.
1. Does this infant have HDFN? If so, what is the most probable cause?
2. What could be causing the positive screen result? How would you confirm?

Exercise 12.3 Additional Testing
An elution is performed. The eluate is tested against A?, B, and O reagent red cells, incubated at 37° C, and tested at the AHG phase:

| | A? | B | O |
| :--- | :--- | :--- | :--- |
| Eluate | 1+ | 1+ | Negative |

3. What do these results indicate?
4. What type of treatment would be recommended for this infant?
5. Is B.W. a candidate for postpartum RhIG? If so, are any additional tests necessary?

Exercise 12.3 Additional Testing
A fetal screen performed on B.W. yields a positive result.
6. What test needs to be performed and why?

Exercise 12.3 Additional Testing
A Kleihauer–Betke stain is performed on B.W.'s postpartum specimen to quantify the amount of FMH. There were 19 fetal cells counted in a total of 2000 cells.
7. How many doses of RhIG should B.W. receive?

Exercise 12.3
B.W. was seen by her OB-GYN at 10 weeks of gestation with her first pregnancy. Results of her prenatal workup indicate she is group O, D-negative with a negative antibody screen. Repeat testing at 28 weeks continues to indicate a negative antibody screen, and she is given 300 ?g of RhIG. The pregnancy proceeds normally, and she delivers a 7 lb 2 oz boy at 39 weeks of gestation. Results of cord blood tests are as follows:

| Anti-A | Anti-B | Anti-D | Weak D | Weak D control | DAT | Mother's Sample Screen cells |
| :— | :— | :— | :— | :— | :— | :— |
| 3+ | 0 | 0 | 1+ | 1+ | 1+ | Weak positive |

Infant hemoglobin is 17.3 g/dL, and bilirubin is 0.6 mg/dL.
1. Does this infant have HDFN? If so, what is the most probable cause?
2. What could be causing the positive screen result? How would you confirm?

Exercise 12.3 Additional Testing
An elution is performed. The eluate is tested against A?, B, and O reagent red cells, incubated at 37° C, and tested at the AHG phase:

| | A? | B | O |
| :— | :— | :— | :— |
| Eluate | 1+ | 1+ | Negative |

3. What do these results indicate?
4. What type of treatment would be recommended for this infant?
5. Is B.W. a candidate for postpartum RhIG? If so, are any additional tests necessary?

Exercise 12.3 Additional Testing
A fetal screen performed on B.W. yields a positive result.
6. What test needs to be performed and why?

Exercise 12.3 Additional Testing
A Kleihauer–Betke stain is performed on B.W.'s postpartum specimen to quantify the amount of FMH. There were 19 fetal cells counted in a total of 2000 cells.
7. How many doses of RhIG should B.W. receive?

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