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RhIG Evaluation – Antenatal

RhIG, RhoGam, Rh Immune Globulin Evaluation, RhIG Evaluation - Antenatal

Test Codes

EPIC: LAB5288, Beaker: RHGAN

Department

Blood Bank

Specimen Collection Criteria

Collect: One Pink-top EDTA tube from an obstetrical patient for Rh typing and possible fetal bleed (FMH) screening.

It is extremely important that blood samples are accurately labeled. Inpatient labels must include the following information:

1. Patient's Name: Complete name.
2. Wrist Band Number:  [Preferred] Include the prefix letters, 4 numbers, and a suffix letter (example: BR1234T).  Wrist Band information is required if sample is to be potentially used for transfusion.
3. Hospital Identification Number: The medical record number must be included on the label.
4. Date and Time Collected
5. Identification of Collector: Employee ID number or first initial and complete last name must be on the sample tube or documented in the computer system.

For Beaumont Reference Laboratory (Outreach) patients, please refer to the Laboratory Bulletin on Laboratory Specimens: How to Label Correctly. 

Physician Office/Draw Specimen Preparation

Maintain specimen at room temperature (20-26°C or 68-78.8°F) or refrigerated (2-8°C or 36-46°F) prior to transport.

Preparation for Courier Transport

Transport: Whole blood at room temperature (20-25°C or 68-77°F) or refrigerated (2-8°C or 36-46°F).

Rejection Criteria

• Improperly labeled specimens.
• Specimens with inadequate volume.
• Specimens collected in inappropriate tubes.
• Specimens contaminated with IV fluids.
• Grossly hemolyzed samples will be tested only in emergency situations.

In-Lab Processing

Centrifuge the specimen upon receipt in the Laboratory.

Storage

Specimen Stability for Testing:

Room Temperature (20-26°C or 68-78.8°F): 24 hours
Refrigerated (2-8°C or 36-46°F): 72 hours
Frozen (-20°C/-4°F or below): Unacceptable

Specimen Storage in Department Prior to Disposal:

Refrigerated (2-8°C or 36-46°F): Specimens are held for a minimum of 7 days.

*Once a sample arrives in Blood Bank, it cannot be shared with other laboratories.

Laboratory

Dearborn Transfusion Medicine Laboratory (Blood Bank)
Farmington Hills Transfusion Medicine Laboratory (Blood Bank)
Grosse Pointe Transfusion Medicine Laboratory (Blood Bank)
Royal Oak Transfusion Medicine Laboratory (Blood Bank)
Trenton Transfusion Medicine Laboratory (Blood Bank)
Troy Transfusion Medicine Laboratory (Blood Bank)
Wayne Transfusion Medicine Laboratory (Blood Bank)

Performed

Sunday – Saturday, 24 hours a day.
Results available within 24 hours for routine requests without unexpected antibodies.

Test Methodology

Work-up for RhIG-Antenatal includes Type and Screen of mother and may include Fetal Maternal Hemorrhage test or Kleihauer-Betke test.

Interpretation

• Candidates for Rh Immune Globulin (RhIG) must be identified in order to prevent immunization to the potent D antigen. All obstetrical patients are considered RhIG candidates until proven otherwise. RhIG is not indicated in the following cases: mother Rho (D) positive or anti-D in mother's serum when mother has not had prenatal Rh Immune Globulin.RhIG may be indicated for obstetrical patients who miscarry, abort, or have amniocentesis. The dose of RhIG administered is determined by the gestation period, and amount of fetal bleed if any.
• RhIG may also be administered prophylactically at 28 weeks gestation to prevent immunization during the third trimester of pregnancy.

Clinical Utility

RhIG is given to Rh negative women postpartum, after termination of pregnancy, abortion, ectopic pregnancy, or trauma in pregnancy (ie fall, or amniocentesis) to prevent development of Anti-D, which may cause erythroblastosis fetalis (hemolytic disease of the newborn) or later, lead to transfusion reaction.

CPT Codes

86900 (ABO), 86901 (Rh), 86850 (Ab Screen), 85461 (FBS). May include Flow and Kleihauer-Betke.

Contacts

Last Updated

11/11/2023