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27 yr old female, G2P1 comes for her prenatal vist at 20th week of gestation. She is a known D (-) and her husband is a known D (+). She recieved RhoGAM at 28wks and immediately postpartum. However her last pregnancy was complicated by abruptio placenta that did not require a C-section. Pt's latest anti-D antibody titer is 1:35. What is the cause of this positive antibody screen

a. low dosage of Rhogam (anti-D immun globulin) at 28wks
b. no prophylaxis in between pregnancies
c. low dosage of rhogam postpartum
d. no prophylaxis earlier in the pregnancy

She recieved standard dose of RhoGAM at 28wks during her last pregnancy and immediately postpartum as well.

JUST WANTED TO MAKE IT CLEAR GUYS!

C--------

answer is C

C

aa

answer is d

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C.

-correct answer is...C.....

Low dose of RhoGam postpartum results in maternal alloimunization.
Rosette test helps to find if there has a feto-maternal hemorrhage. If it is positive you go on to do the KLEIHAUER-BETKE TEST...this will help us adjust the dose of RhoGam.

so if more blood transfered into mom...more antibody production...and dose of Rhogam goes up....this is how i look at it... if you disagree let me know.