Should we continue screening rhesus D positive women for the development of atypical antibodies in late pregnancy?

Hull and East Yorkshire Hospitals, Hull Royal Infirmary, Hull, UK.
Journal of Maternal-Fetal and Neonatal Medicine (Impact Factor: 1.37). 02/2007; 20(1):59-61. DOI: 10.1080/14767050601123317
Source: PubMed


The purpose of this study was to calculate the incidence of the new development of atypical antibodies (other than anti-rhesus D) in women attending for antenatal care, and to assess the clinical impact and cost-effectiveness of a second test to detect these antibodies.
A three-year retrospective analysis was undertaken to calculate the number of rhesus positive women who developed new antibodies in the last trimester of pregnancy.
Of 13,143 rhesus positive women, 20 (0.15%) developed new antibodies; fetal outcome was not compromised in any of these cases.
Repeat testing in late pregnancy would appear an unnecessary expense in our population.

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    • "The available data from other countries date back to 90s but it is interesting that the prevalence of maternal alloimmunisation in Greece in the past few years is still slightly higher than rates of alloimmunisation elsewhere in Europe and in North America over 15 years ago (Heddle et al., 1993; Filbey et al., 1995; Rothenberg et al., 1999; Lee et al., 2003; Adeniji et al., 2007). Of the 41 alloantibodies detected in 39 alloimmunised women, 37 alloantibodies (excluding 4 with anti-Lea specificity) were clinically significant and could cause HDFN. "
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    ABSTRACT: To access the incidence and specificity of maternal red blood cells alloimmunisation and its relevant clinical impact in Greece. The rate of alloimmunisation in pregnant women in Greece is unknown. We performed a 4-year study in two tertiary hospitals in Greece. Demographics, transfusion and obstetric history were analysed. Maternal alloimmunisation was detected with indirect anti-globulin test. We investigated 4368 pregnant women. Of which 3292 (75·37%) were Greek and 1076 (24·63%) were migrants. In 39 alloimmunised women, 41 alloantibodies were detected (0·89%). The incidence of alloimmunisation was 0·66% (22/3292) in Greeks and 1·76% (17/1076) in migrants (P = 0·01). Anti-D was the most frequent alloantibody (0·18%). Anti-D was more frequent in migrants; 5·76% compared to 0·56% in Greek RhD negative women (P = 0·002). Other antibody specificities in declining frequency rank were anti-K, anti-E, anti-Lea, anti-M, anti-c, anti-Ce, anti-Jka, anti-Jkb and anti-C. Primiparae vs para >2 and past history of blood transfusion were significantly associated with alloimmunisation during pregnancy (P = 0·0088, P < 0·0001, respectively). Our results depict differences in the delivery of health care between migrants and Greek women, as well as the heterogeneity in practices for the prevention of haemolytic disease of foetus and newborn in Greece and highlight the need for the implementation of nationwide guidelines.
    Transfusion Medicine 07/2013; 23(4). DOI:10.1111/tme.12063 · 1.65 Impact Factor
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    ABSTRACT: Background. Neonatal jaundice is a clinical event frequently present in newborns. The causes most frequently involved in hemolytic disease of newborn (HDN) are still the incompatibilities to the ABO/Rh blood system. Direct Coombs test (or direct antiglobulin test, DAT) allows identification of the presence of red blood cell antibodies (IgG isotype) coming from the maternal serum on the surface of the fetus erythrocytes. The purpose of this study is to show the results and specificity of DAT as screening in newborn infants.
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