From Georgetown University Hospital, Washington, DC.
Obstet Gynecol. 2012 Feb;119(2 Pt 2):426-428. doi: 10.1097/AOG.0b013e31823f6f76.
A woman's candidacy for Rh immune globulin depends on whether her blood type is Rh-positive (D antigen-positive) or Rh-negative (D antigen-negative). New molecular blood-typing methods have identified variant D antigens, which may be reported as Rh-positive or Rh-negative depending on the laboratory method. We describe a case illustrating the effect of the new laboratory methods on a woman's candidacy for Rh immune globulin and present recommendations for interpreting the new test results.
A 40-year-old woman presented for management of her third pregnancy. During her first pregnancy, she was typed as Rh-positive ("D") and did not receive Rh immune globulin. During her second pregnancy, she was typed as Rh-negative, in accordance with revised Rh-typing procedures. Anti-D antibody was detected. During her third pregnancy, she was genotyped as a partial D antigen, which was reported as Rh-negative.
Revisions in laboratory procedures for Rh typing may present as a change in the Rh blood type of pregnant women-and as a change in their eligibility for Rh immune globulin.
女性是否适合接受 Rh 免疫球蛋白取决于其血型是 Rh 阳性（D 抗原阳性）还是 Rh 阴性（D 抗原阴性）。新的分子血型检测方法已经鉴定出了变异的 D 抗原，根据实验室方法的不同，这些抗原可能被报告为 Rh 阳性或 Rh 阴性。我们描述了一个病例，说明了新实验室方法对女性接受 Rh 免疫球蛋白的影响，并提出了解释新检测结果的建议。
一名 40 岁女性因第三次妊娠就诊。她第一次妊娠时被定型为 Rh 阳性（“D”），未接受 Rh 免疫球蛋白。第二次妊娠时，根据修订后的 Rh 定型程序，她被定型为 Rh 阴性。检测到抗-D 抗体。第三次妊娠时，她的基因型为部分 D 抗原，报告为 Rh 阴性。
实验室 Rh 定型程序的修订可能会导致孕妇的 Rh 血型发生变化，以及她们是否有资格接受 Rh 免疫球蛋白。
