Weak D in Pregnancy

  • Meghan DelaneyEmail author


It is important to determine if a patient is RhD positive or negative for the purposes of transfusion and pregnancy. Occasionally, the RhD type is not able to be resulted or the result differs from results obtained in the past due to underlying genetic variation in the RHD gene. In these cases, it is important to do further testing using genotype testing to determine if the woman should be managed as RhD positive or RhD negative. If a woman of child-bearing potential makes anti-D antibody, her future pregnancies are at risk of hemolytic disease of the fetus and newborn (HDFN) if a fetus is RhD positive. RhIg is used to protect RhD negative women from this HDFN due to anti-D sensitization. These critical decisions are informed by clarifying the RhD type.


Weak D Red blood cell genotyping Immunohematology Obstetrics Prenatal 


  1. 1.
    Westhoff CM. The structure and function of the Rh antigen complex. Semin Hematol. 2007;44:42.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Denomme GA, Wagner FF, Fernandes BJ, Li W, Flegel WA. Partial D, weak D types, and novel RHD alleles among 33,864 multiethnic patients: implications for anti-D alloimmunization and prevention. Transfusion. 2005;45:1554.CrossRefPubMedGoogle Scholar
  3. 3.
    Haspel RL, Westhoff CM. How do I manage Rh typing in obstetric patients? Transfusion. 2015;55:470–4.CrossRefPubMedGoogle Scholar
  4. 4.
    Sandler SG, Roseff SD, Domen RE, Shaz B, Gottschall JL. Policies and procedures related to testing for weak D phenotypes and administration of Rh immune globulin: results and recommendations related to supplemental questions in the comprehensive transfusion medicine survey of the College of American Pathologists. Arch Pathol Lab Med. 2014;138:620–5.CrossRefPubMedGoogle Scholar
  5. 5.
    Sandler SG, Flegel WA, Westhoff CM, et al. It’s time to phase in RHD genotyping for patients with a serologic weak D phenotype. Transfusion. 2015;55:680–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Kacker S, Vassallo R, Keller MA, et al. Financial implications of RHD genotyping of pregnant women with a serologic weak D phenotype. Transfusion. 2015;55:2095–103.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Yazer MH, Brunker PA, Bakdash S, et al. Low incidence of D alloimmunization among patients with a serologic weak D phenotype after D+ transfusion. Transfusion. 2016;56:2502–9.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Pathology and Laboratory MedicineChildren’s National Health SystemWashington, DCUSA
  2. 2.George Washington UniversityWashington, DCUSA

Personalised recommendations