LQCL2517 - CMLE - Rh Immune Globulin Candidacy and Testing-LQCL2517

LQCL2517 - Educational Activity

Pdf Summary

The document provides a comprehensive overview of transfusion medicine with a focus on Rh immune globulin (RhIG) administration and related testing methodologies. The learning objectives include determining patient candidacy for RhIG, understanding results of fetal screen tests, and evaluating false positive results. A case study is highlighted involving a 23-year-old Rh(D) negative woman in labor whose newborn is Rh(D) positive. This prompts the performance of a qualitative fetal screen, which yielded unexpectedly positive results indicating possible fetal-maternal hemorrhage (FMH).<br /><br />The qualitative fetal screen, or fetal rosette test, is used to detect Rh(D) positive fetal red blood cells in a Rh(D) negative mother's circulation to assess FMH. Issues such as false positives can arise due to factors like improper technique or maternal "weak" D positive status.<br /><br />The case resolution involved re-evaluation of the testing process to eliminate errors. The abnormal result was determined to be a false positive due to the mother's "weak" D status, making her ineligible for the test. Subsequently, a quantitative FMH test was suggested and a decision to administer RhIG was made to prevent alloimmunization, pending specific "weak" D type confirmation.<br /><br />The summary highlights that hospitals frequently test mothers for RhIG candidacy, especially if they are Rh(D) negative and the newborn is Rh(D) positive. For "weak" D positive mothers, mechanisms such as quantitative tests help determine RhIG and transfusion strategies. The document concludes with a 'Did You Know?' section noting the urgency of RhIG administration within 72 hours post-delivery for efficacy, often precluding detailed "weak" D type determination.<br /><br />The document also includes questions for understanding RhIG administration and testing based on scenarios and expected outcomes, furthering practical knowledge in transfusion medicine.

Keywords

transfusion medicine

Rh immune globulin

RhIG administration

fetal screen test

false positive

fetal-maternal hemorrhage

weak D status

alloimmunization

quantitative FMH test

Rh(D) negative