Maternal blood In the United States, it is a standard of care to test all expecting mothers for the presence or absence of the<unk> D protein on their RBCs. However, when medical care is unavailable or prenatal care not given for any other reason, the window to prevent the<unk>  may be missed. In addition, there is more widespread use of molecular techniques to avoid missing women who appear to be<unk> -D positive but are actually missing portions of the protein or have hybrid genes creating altered expression of the protein and still at risk of HDFN due to Anti-D. * At the first prenatal visit, the mother is typed for ABO blood type and the presence or absence of<unk> D using a method sensitive enough to detect weaker versions of this antigen (known as weak-D) and a screen for antibodies is performed. * If she is negative for<unk> D protein expression and has not formed anti-D already, she is a candidate for<unk> oGam prophylaxis to prevent alloimmunization. * If she is positive for anti-D antibodies, the pregnancy will be followed with monthly titers (levels) of the antibody to determine if any further intervention is needed. * A screening test to detect for the presence or absence of fetal cells can help determine if a quantitative test (Kleihauer-Betke or flow cytometry) is needed. This is done when exposure is suspected due to a potential sensitizing event (such as a car accident or miscarriage). * If the screening test is positive or the appropriate dose of<unk> oGam needs to be determined, a quantitative test is performed to determine a more precise amount of fetal blood to which the mother has been exposed. * The Kleihauer–Betke test or Flow Cytometry on a maternal blood sample are the most common ways to determine this, and the appropriate dose of<unk> oGam is calculated based on this information. * There are also emerging tests using Cell-free DNA. Blood is taken from the mother, and using PCR, can detect fetal DNA. This blood test is non-invasive to the fetus and can help determine the risk of HDFN. Testing has proven very accurate and is routinely done in the UK at the International Blood Group Reference Laboratory in Bristol. Paternal blood Blood is generally drawn from the father to help determine fetal antigen status. If he is homozygous for the antigen, there is a 100% chance of all offspring in the pairing to be positive for the antigen and at risk for HDFN. If he is heterozygous, there is a 50% chance of offspring to be positive for the antigen.
Rh disease
Rh deficiency syndrome
3-M syndrome
Fanconi anemia
3C syndrome
Leukocyte adhesion deficiency-1
X linked thrombocytopenia
NEMO deficiency syndrome