Management of red blood cell alloimmunization in pregnancy

Ghesquière, Louise; Garabédian, Charles; Coulon, C.; Verpillat, P.; Rakza, Thameur; Wibaut, B.; Delsalle, A; Subtil, D.; Vaast, P.; Debarge, V.

doi:10.1016/j.jogoh.2018.02.001

Cited by 28 publications

(33 citation statements)

References 68 publications

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“…The inter-individual variation in red blood cell surface proteins defines the range of clinically observed blood types, from the main Rhesus grouping to more minor Landsteiner-Weiner system 1 . Appreciation of the variability of RBC surface proteins is vital to the understanding of transfusion compatibility between donors and recipients, and conditions such as haemolytic disease of the newborn 2 .…”

Section: Introductionmentioning

confidence: 99%

Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations

et al. 2019

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Red blood cells (RBCs) play a critical role in oxygen transport, and are the focus of important diseases including malaria and the haemoglobinopathies. Proteins at the RBC surface can determine susceptibility to disease, however previous studies classifying the RBC proteome have not used specific strategies directed at enriching cell surface proteins. Furthermore, there has been no systematic analysis of variation in abundance of RBC surface proteins between genetically disparate human populations. These questions are important to inform not only basic RBC biology but additionally to identify novel candidate receptors for malarial parasites. Here, we use ‘plasma membrane profiling’ and tandem mass tag-based mass spectrometry to enrich and quantify primary RBC cell surface proteins from two sets of nine donors from the UK or Senegal. We define a RBC surface proteome and identify potential Plasmodium receptors based on either diminished protein abundance, or increased variation in RBCs from West African individuals.

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Section: Introductionmentioning

confidence: 99%

Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations

et al. 2019

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“…In some instances such as miscarriage, abortion, trauma, childbirth and invasive prenatal diagnosis viz. chorionic villous sampling, amniocentesis, and pregnancy related uterine curettage may lead to feto-maternal haemorrhage thereby causing maternal exposure to foetal blood and consequently leading to alloimmunization [48]. The risk of Rh D immunization is estimated to be 1.5-2% in sensitized women following spontaneous miscarriage and 4-5% after dilation and curettage [49,50].…”

Section: Rh Alloimmunizationmentioning

confidence: 99%

“…Foetal anaemia can be diagnosed using ultrasound, cardiotocography and cordocentesis [48]. High resolution ultrasonography has supported in early diagnosis of early hydrops and has also lowered the foetal trauma and fatality rate to approximately 2% while performing percutaneous umbilical blood sampling (PUBS) and placental trauma during amniocentesis.…”

Section: Disease Caused Due To Alloimmunization In Pregnancy 41 Haemmentioning

confidence: 99%

Alloimmunization and Role of HLA in Pregnancy

Singh¹,

Rajak²,

Rajadhyaksha³

2019

Complications of Pregnancy

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Alloimmunization also known as isoimmunization, during pregnancy is the production of IgG antibodies by the mother against the paternally inherited antigens (IPA) in the foetus/newborn. The alloimmunization during pregnancy leads to various alloimmune disorders, such as, haemolytic disease of the foetus and newborn (HDFN), neonatal alloimmune neutropenia (NAN) and foetal and neonatal alloimmune thrombocytopenia (FNAIT) due to the production of maternal alloantibodies against the red blood cell antigen, neutrophils and platelets cell antigens, respectively. Recent studies suggest that maternal anti-HLA class I alloantibodies may also be the cause of FNAIT in addition to antibodies against platelet antigens. On the contrary, studies have also suggested that HLA-C, a classical HLA class I molecule, and HLA-G, a nonclassical HLA molecule, play an important role in placentation and modulation of the maternal immune system during pregnancy, respectively, and thereby leading to acceptance of the semi allogeneic fetus. So far most of the studies have discussed alloimmunization in pregnancy relating to Rh antigen. Thus, in this chapter an attempt has been made to discuss alloimmunization in pregnancy caused because of maternal alloantibody against HLA antigen and its role in immune modulation during pregnancy.

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“…Pregnant women with antibodies (anti-D, anti-c and anti-K) known for having the potential to cause clinically significant HDFN are monitored more frequently, according to established algorithms which define the frequency of testing, measurement of antibody concentration, referrals to specialist examinations, monitoring after childbirth, etc. [6][7][8]. In the case of immunization, child's biological father is also being tested (ABO blood group, Rh phenotype, the presence of the specific antigen).…”

Section: Introductionmentioning

confidence: 99%

“…Collecting fetal blood by cordocentesis was also becoming rare due to a high risk of complications to the child [4]. Monitoring of alloimmunized pregnancies with a risk of fetal anemia is possible using the fetal middle cerebral artery Doppler [4,7].…”

Section: Introductionmentioning

confidence: 99%

Red blood cell alloimmunization in pregnancy: A 10-year single-center study

2022

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Background/Aim. Pregnancy-induced red blood cell (RBC) alloimmunization is important not only because of the possible negative effects on subsequent pregnancy outcomes, in case the fetus carries the antigen, but also because of the optimal transfusion management in cases of obstetric haemorrhage. Timely detection of RBC antibodies is part of a testing, prevention and treatment strategy aimed at achieving better outcomes for alloimmunized mothers with an affected fetus. The aim was to determine the frequency and specificity of alloantibodies among pregnant women from the South Backa District, with special attention to the incidence of anti-D alloantibody. Methods. A retrospective study was conducted from January 1, 2010 to December 31, 2019 in the Blood Transfusion Institute of Vojvodina. Screening and antibody identification were performed by an indirect antiglobulin test in gel-microcards (ID-Card Liss/Coombs) with two test RBC (ID-DiaCell I-II screening cells, Bio-Rad, Cressier, Switzerland), on an automated system (IH-500, Bio-Rad). Results. Among 25694 tested pregnant women 1.38% were actively immunized, while 1.12% antibodies was identified in the current pregnancy. Among 3622 (14.09%) RhD-negative women 1.77% with anti-D produced during the ongoing pregnancy were found. Distribution of antibody specificity was: anti-D 23.34%, anti-M 11.85%, anti-E 9.41%, anti-K 9.41%, anti-C 5.92%, anti-Fyb 5.92%, anti-c 3.13%, anti-S 3.13%, anti-Lea 3.13%, anti-Leb 3.13%, anti-Cw 1.75%, anti-Jka 1.40%, anti-P 1.05%, anti-Lub 0.70%, anti-Fya 0.35%, autoantibody of undetermined specificity 0.70%, and irregular antibodies of undetermined specificity 15.68%. Conclusion. Immune globulin prophylaxis has led to a significant reduction in the frequency of D alloimmunization among pregnant women in the South Backa District over the last ten years, but the incidence of anti-D is still significantly higher than in published data for developed countries. We also identified the other, less commonly present, clinically significant antibodies. There is a need to introduce uniform recommendations for immunohematological testing in pregnancy on the territory of the Republic of Serbia, in accordance with modern requirements.

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Management of red blood cell alloimmunization in pregnancy

Cited by 28 publications

References 68 publications

Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations

Quantitative comparative analysis of human erythrocyte surface proteins between individuals from two genetically distinct populations

Alloimmunization and Role of HLA in Pregnancy

Red blood cell alloimmunization in pregnancy: A 10-year single-center study

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