Is a type and screen required before administering Rhogam (Rho(D) immune globulin)?

Type and Screen Before Rhogam Administration

No, a type and screen is NOT required before administering Rhogam (Rho(D) immune globulin), though blood typing to confirm Rh-negative status should be performed at some point during pregnancy care. 1

Blood Typing Requirements

• All pregnant women should be typed and screened for alloantibodies with an indirect antiglobulin test at the first prenatal visit and again at 28 weeks gestation. 2 This establishes baseline Rh status and detects any pre-existing sensitization.

• If blood type results from earlier in pregnancy are available, antibody screening does not need to be repeated at the time of abortion or other potentially sensitizing events. 2

• The primary purpose of typing is to identify Rh-negative women who need RhIg prophylaxis, not to perform a formal "type and screen" immediately before each RhIg dose. 1

When RhIg Can Be Given Without Immediate Testing

• If there is any doubt about the mother's Rh type, she should be given Rho(D) Immune Globulin. 3 This FDA guidance supports erring on the side of administration when typing is uncertain.

• In settings where requiring RhD testing could delay abortion care or pose logistical barriers, patients should be counseled on the implications of unknown blood type and possible risks of non-administration, but the priority is completing the abortion. 4

• Women with "weak D" (Du-positive) should NOT receive anti-D, making accurate typing important when feasible. 2

Critical Distinction: Typing vs. Crossmatching

The question asks about "type and screen," which typically refers to blood bank procedures for transfusion preparation. RhIg administration does not require crossmatching or compatibility testing—only knowledge of the mother's Rh-negative status. 1, 2

Practical Clinical Algorithm

1. Ideally: Confirm Rh-negative status from prenatal records or prior testing 2
2. If unknown and testing available: Perform simple Rh typing (not full type and screen) 2
3. If unknown and testing unavailable: Administer RhIg if clinically indicated, as the risks of administration are low compared to potential consequences of sensitization 4, 3
4. Never delay: Do not postpone RhIg administration beyond 72 hours waiting for typing results if the clinical scenario warrants prophylaxis 1, 2

Common Pitfall to Avoid

Do not confuse the need for baseline blood typing during pregnancy (which is standard prenatal care) with requiring a formal type and screen procedure before each RhIg dose. 2 The former establishes Rh status once; the latter is unnecessary for RhIg administration and could create harmful delays in time-sensitive situations where the 72-hour window is critical. 1