This question is in three parts:

a) Discuss the pathophysiology of haemolytic disease of the newborn caused by anti-D.

b) Critically evaluate the tests available for investigation of a woman who is 29 weeks pregnant and who has had abdominal trauma following a fall. Her “group & screen” test states A negative with anti-D detected. 

c) Discuss the laboratory investgation and clinical management of a woman in her 2nd pregnancy who is found to have anti-D of 20.9 IU/ml in her plasma for the first time at 36 weeks gestation