In:
Transfusion, Wiley, Vol. 58, No. 2 ( 2018-02), p. 294-305
Abstract:
In addition to titration by indirect antiglobulin test most widely used, anti‐D quantitation by continuous‐flow analysis (CFA) may be performed to assess severity of maternal immunization. Only five studies have reported its added value in the management of pregnancies complicated by anti‐D immunization. STUDY DESIGN AND METHODS A retrospective study of 74 severe anti‐D–immunized pregnancies was conducted from January 1, 2013, to December 31, 2014, in the Trousseau Hospital in Paris (France). Concentration of maternal anti‐D was measured by titration and by CFA two‐stages method (2SM; total amount of anti‐D) and one‐stage method (1SM; high‐affinity IgG1 anti‐D). These biologic data were analyzed according to the severity of the hemolytic disease of the fetus and the newborn. RESULTS The value of 5 IU anti‐D/mL in maternal serum is validated as a threshold to trigger ultrasonographic and Doppler fetal close follow‐up. A high 1SM/2SM ratio was associated with a higher risk of intrauterine transfusion (IUT). For pregnancies requiring IUT and without increasing titer, maternal 1SM anti‐D concentration tends to correlate with the precocity of fetal anemia. In the “without‐IUT” group 1SM and 2SM anti‐D concentrations correlate significantly with cord bilirubin levels of the newborn at birth. CONCLUSION Altogether our results underline the importance of anti‐D quantitation by CFA to optimize the management of anti‐D–alloimmunized pregnancies.
Type of Medium:
Online Resource
ISSN:
0041-1132
,
1537-2995
DOI:
10.1111/trf.2018.58.issue-2
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2018415-3