Consequences of erroneous reporting and interpretation of positive antibody screen in Rhesus (Rh) negative pregnancy: A report of two cases

Abstract

Background Rhesus (Rh) D Immunoglobulin (RhIG), ( Rhogam®) is indicated for all pregnant Rh-negative women at 28 weeks of gestation followed by a second dose within 72 h after birth if the newborn is Rh-positive and it reduces the risk for Rh alloimmunization of the mother from 13%–16% to 0.1%–0.2%. Methods Retrospective review of causes and outcomes of two cases of Rh-induced hemolytic disease of the newborn (Rh-HDN) at our institution. Results The determination of passive anti-D from RhIG versus active anti-D from maternal sensitization and subsequent management, relies entirely on a reliable history of prior and timely RhIG administration in the mother. Conclusion These two cases illustrate the importance of communication (and the detriment of the lack thereof) between blood bank and maternal—and neonatal care providers in the prevention—and management of Rh-HDN.