Monitoring fetal maternal incompatibility, a retrospective study – In a Spanish
population attending the Parc de Salut, Mar in Barcelona
Mari Raya Hinojosa Raya, Pedro Carrasco Rupérez , Jéssica Estrela, Nádia Osório, Ana valado,
Armando Caseiro, António Gabriel, Mercedes López Soques, Fernando Mendes
Int. J. Bio. Lab. Sci 2016 5:1-8
Introduction: Hemolytic disease of the fetus and newborn (HDFN) continues to be a complication of early life in the newborn. Prophylaxis by administration of anti-D immunoglobulin IgG to Rh D negative pregnant women at 28 weeks and postpartum is a standard practice and the study of irregular antibodies (Ab) to all pregnant women has contributed to the detection of other Ab capable of inducing HDFN.
Aims: To determine the current frequency and incidence of maternal alloimmunization, severity of hemolytic disease and determine the frequency of Rh D negative pregnant resulting in newborn Rh D negative, where the administration of gamma globulin could have been avoided.
Methods: Retrospective study. We evaluated for two years, a total of 7087 tests in pregnant women and in 6224 newborns of the Blood Bank Parc Salut Mar of Barcelona. The positive results of indirect antiglobulin test and direct antiglobulin test were reviewed. The study of Ab was performed using plasma from pregnant women with 3-cell ID DiaCell I-II-III card. In positive tests it was used panel 11-cell ID with a DiaPanel autologous cell and 11-cell NaCl ID card, enzymatic assay and cold agglutinins and Media-Liss Coombs.
Results: The frequency of maternal active alloimmunization was 39 in 3.118 pregnant women (1.25 in 100). 2 cases of severe HDFN among 3.000 newborns were observed which yield a prevalence of severe hemolytic disease of 1 in 1500.
Conclusion: Most Ab detected corresponds to Ab against the Rh system. The anti-D Ab detected in our studies are mostly passive antibody administration remains IgG anti-D prophylaxis. The politics of fetal Rh-D genotyping in maternal plasma in all pregnant negative D should be implemented in order to prevent IgG anti-D administration of prophylaxis if the fetus is also D negative.
Key words: Newborn hemolytic disease, Rh-D, genotyping, maternal