Consumption of anti-D in the erythroblastotic fetus

Abstract

Fetal anti-D is consumed in the hemolytic process and the consumption can be modulated by i.v.IG given to the mother.

RhD Isoimmunization and Current Management Modalities

“…Fetal serum anti-D normally is positively correlated to maternal serum anti-D concentration (Gottvall & Selbing, 1998). However, it was theorized that the phagocytosis and hemolysis of fetal red blood cells in RhD isoimmunization may result in a simultaneous increased consumption of anti-D with subsequently lower than expected serum anti-D concentrations in affected fetuses.…”

“…However, it was theorized that the phagocytosis and hemolysis of fetal red blood cells in RhD isoimmunization may result in a simultaneous increased consumption of anti-D with subsequently lower than expected serum anti-D concentrations in affected fetuses. Gottvall and Selbing (1998) studied the consumption of anti-D in RhD-positive erythroblastotic fetuses in comparison to phenotypically RhDnegative fetuses and RhD-positive fetuses indirectly treated with high-dose immunoglobulins given to the mother. They found that fetuses with an RhD-negative phenotype expressed an increase from 10% to 55% in fetaVmaterna1 anti-D concentration ratios between 25 and 3 1 gestational weeks, whereas RhD-positive fetuses without high-dose immunoglobulins treatment had stable values at the 10% level between 24 and 35 weeks.…”