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RhD determination in pregnant women is critical to facilitate Rh immune globulin prophylaxis for RhD-negative women. A single amino acid change in the RhD antigen can cause epitope loss, giving rise to "partial D" variants. Women with some partial D variants may develop anti-D against the missing epitope after pregnancy. RBCs with partial D may type as D-positive or D-negative depending on the reagent used. We screened routine blood bank samples from 501 prenatal patients for RhD variants by 3 commercially available serologic methods. Discordant serologic results were found in 11 cases. Weak D (n = 5) and partial D (n = 5) variants were confirmed by molecular genotyping in all but 1 case. RhD variants, confirmed molecularly, occur in 2.2% of our multiethnic population. Consideration of patients' ethnic background and close cooperation between pathologists and obstetric providers facilitate optimal prenatal care in these cases.

Prevalence of RhD Variants, Confirmed by Molecular Genotyping, in a Multiethnic Prenatal Population