4. A 32-year-old female was admitted to hospital in active labour at term with h

Question

4. A 32-year-old female was admitted to hospital in active labour at term with her first baby. After 8 hours there were signs of foetal distress and she was taken for an emergency h progress, of labour with not muc Caesarian section. The baby was soon delivered and was healthy. After 3 days of care, mother and baby were discharged. A week later, the mother returned to the emergency room (ER) of the hospital with complaints of extreme weakness, mild jaundice, and some back pain. An automated CBC revealed a haemoglobin of 6.9 g/dL and hematocrit of 21.3%. The ER physician ordered 3 units of red cells for urgent transfusion. A sample was drawn and sent to the blood bank. The blood bank tested her samples and got the following results. The technologist performing the testing commented that the EDTA plasma and serum were dark red, but the phlebotomist denied having difficulty drawing the samples. ABO/Rh typing RBC (forward) typing Anti-A Anti-B Anti-D Serum (reverse) typing Al cells 6% albumin B cells 0 Antibody Screen IS LISS 37°C IAT Anti-IgG Auto control Not tested (a) What is the patient's ABO/Rh? (b) What are the results of the antibody screening? (c) Are there any atypical results worth pursuing before setting up the crossmatch? (2 marks) (2 marks) (4 marks) Further testing reveals the following: Direct antiglobulin test (DAT): Polyspecific Anti-IgG Anti-C3 6% albumin Patient's cells Eluate prepared from the DAT+ RBCs: IAT Anti-IgG Antibody screening Eluate Last wash S II 0 Auto control (d) Explain the principle and purpose of direct antiglobulin test (DAT) and indirect antiglobulin test (IAT). (e) What do the results of the DAT suggest? (f What do the results of the eluate suggest? 6 marks) (2 marks) (4 marks)

Explanation / Answer

ABO/Rh typing

a) Her blood group is B, Rh- Positive.

b) The antibody screening shows that the antibodies in her serum are Anti-A.

c)

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