The significance of anti-C sensitization in pregnancy

Bowell, P. J.; Inskip, M. J.; Jones, M. N.

doi:10.1111/j.1365-2257.1988.tb00018.x

Cited by 11 publications

(9 citation statements)

References 5 publications

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“…Anti-C, which was found to be most frequent in this study, corroborates results in other studies where it was found to be most frequent7–1012 HDFN caused by anti-C is usually mild as the C antigen has weak immunogenicity. [10]…”

Section: Discussionsupporting

confidence: 91%

Frequencies of maternal red blood cell alloantibodies in Port Harcourt, Nigeria

Jeremiah

Mordi

Buseri

et al. 2011

Asian J Transfus Sci

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Background:Alloantibodies of clinical importance can cause transfusion reactions or hemolytic disease of the fetus and newborn (HDFN). The frequencies of these antibodies have not been reported in our locality.Aims:To determine the frequency of occurrence of alloantibodies among pregnant women in Port Harcourt, Nigeria.Settings and Design:This is a prospective study, which was carried out in the Braithwaite Memorial Specialist Hospital, Port Harcourt, Nigeria.Materials and Methods:Screening and identification of red blood cell alloantibodies was done on the sera of 500 pregnant women using the DiaMed, DiaCell, and DiaPanel reagents (Cressier, Switzerland). ABO and Rh blood groups were done using antisera bought from Biotec (Ipswich, UK).Results:Alloantibodies were identified in the serum of 17 of the 500 (3.4%) pregnant women. The specificity of the antibodies was as follows: anti-C 6 (1.2%), anti-E 3 (0.6%), anti-Jsb 3 (0.6%), and anti-K 5 (1.0%). No anti-D was identified despite 8.6% of the study population being Rhesus D (Rh D) negative. The distribution of the antibodies was found to be independent of the blood groups of the participants (χ2 = 4.050, P = 0.670). Blood group O constituted the highest percentage (48.0%).Conclusion:This study has identified the presence of non-Rh D antibodies to the proportion of 3.4%. Rh D antibody was absent in this population irrespective of the relatively high percentage of Rh D negative women. There is a need to determine the actual risk these antibodies may pose to the antenatal women and to include antibody screening and identification in routine antenatal care.

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Section: Discussionsupporting

confidence: 91%

Frequencies of maternal red blood cell alloantibodies in Port Harcourt, Nigeria

Jeremiah

Mordi

Buseri

et al. 2011

Asian J Transfus Sci

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“…In various retrospective studies, haemolytic disease of the newborn has been reported due to Anti-c antibodies [9-11]. The frequency of D and Non-D antigens differ in different populations with respect to their ethnic origin [12-14].…”

Section: Discussionmentioning

confidence: 99%

“…It is important to check that patients with anti-c antibodies do not have any additional antibodies for although these might not compound any HDFN, they would certainly delay the provision of compatible blood for transfusion [9]. Bowell et al .…”

Section: Discussionmentioning

confidence: 99%

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Severe hydrops in the infant of a Rhesus D-positive mother due to anti-c antibodies diagnosed antenatally: a case report

et al. 2010

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IntroductionRhesus haemolytic disease of the newborn is a prototype of maternal isoimmunisation and fetal haemolytic disease. There are other rare blood group antigens capable of causing alloimmunisation and haemolytic disease such as c, C, E, Kell and Duffy. In India, after the confirmation of a newborn's blood group, antibodies are screened only if the mother is Rehsus D-negative negative and the father is Rhesus D-positive. Hydrops in Rhesus positive women are investigated along the lines of non-immune hydrops.Case presentationWe report the case of a patient from India where irregular antibodies were requested for an O-positive 26-year-old mother in order to investigate fetal hydrops. Anti-c antibody was revealed and the fetus was treated successfully with compatible O negative and c negative intrauterine blood transfusions. The baby was treated postnatally with double volume exchange transfusion with the same compatible blood, and was discharged 30 days after birth.ConclusionWe highlight the importance of conducting irregular antibody screening for women with significant obstetric history and fetal hydrops. This could assist in diagnosing and successfully treating the fetus with appropriate antigen negative cross-matched compatible blood. We note, however, that anti-c immunoglobulin is not yet readily available.

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“…Las transfusiones intrauterinas son infrecuentes en enfermedad hemolítica perinatal por estos anticuerpos (4). En las series de casos publicados por isoinmunización por RhC, la mayoría de los recién nacidos no fueron afectados por enfermedad hemolítica perinatal; sin embargo, un grupo de ellos requirió tratamiento posparto por enfermedad moderada a severa (16,17). En relación a la isoinmunización por RhE, Leve a severa Leve a severa…”

Section: Isoinmunización Por Anticuerpos Irregulares I Sistema Rhesuunclassified

Manejo de la embarazada con isoinmunización por anticuerpos irregulares

2014

Rev. chil. obstet. ginecol.

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RESUMENLa isoinmunización eritrocitaria feto-materna se define como la presencia de anticuerpos maternos dirigidos contra antígenos presentes en los glóbulos rojos fetales. Los anticuerpos maternos pueden atravesar la barrera placentaria y provocar hemólisis de los glóbulos rojos fetales produciendo anemia hemolítica e hiperbilirrubinemia, características de la enfermedad hemolítica perinatal (EHP). La principal causa de EHP es la incompatibilidad ABO, seguida de la isoinmunización por RhD; esta última ha disminuido su incidencia dado el amplio uso de inmunoglobulina anti D. Sin embargo, el glóbulo rojo tiene más de 400 antígenos, muchos de ellos (>50) capaces de producir isoinmunización y EHP. En este artículo, revisamos la evidencia y proponemos un algoritmo de manejo y seguimiento de las embarazadas con isoinmunización por anticuerpos irregulares. En la isoinmunización por anticuerpos irregulares, los títulos de anticuerpos maternos no se correlacionan con la gravedad de la enfermedad. La anemia en la EHP por anticuerpos anti-Kell es secundaria a una supresión de la eritroblastosis fetal a diferencia del resto de los sistemas que producen anemia hemolítica. Recomendamos efectuar tamizaje de todas las pacientes en el control prenatal, solicitando grupo sanguíneo, Rh y test de Coombs indirecto. En las pacientes Rh (+) con test de Coombs indirecto positivo es necesario identificar los anticuerpos irregulares. En caso de tener isoinmunización por anticuerpos irregulares con riesgo de EHP, derivar a una unidad de alto riesgo obstétrico para realizar seguimiento de la aparición de anemia fetal midiendo de modo seriado el peak sistólico de la arteria cerebral media. Si se detecta anemia fetal, debemos planificar una cordocentesis para confirmar el diagnóstico y tratar la anemia. PALABRAS CLAVE: Isoinmunización, anticuerpos irregulares, enfermedad hemolítica perinatal SUMMARYThe fetomaternal erythrocyte isoimmunization is defined as the presence of maternal antibodies directed against antigens present in fetal red blood cells. Maternal antibodies can cross the placenta and cause hemolysis of fetal red blood cells causing hyperbilirubinemia and hemolytic anemia, known as perinatal hemolytic disease (PHD). The main cause of PHD is ABO incompatibility, followed by RhD isoimmunization. The latter has decreased its incidence since the widespread use of anti-D immunoglobulin. However, the red cell has more than 400 antigens; many of them (>50) can lead to isoimmunization and PHD. In this article, we review the evidence and propose an algorithm for the management and monitoring of pregnant women with irregular antibodies isoimmunization. In the isoimmunization by irregular antibodies, maternal antibody titers do not correlate with the severity of the disease. Anemia in PHD by anti-Kell is secondary to suppression of fetal erythroblastosis unlike other systems that produce hemolytic anemia. We suggest the screening of all patients in the prenatal control with blood group, Rh and indirect Coombs test. In the Rh (+) patients w...

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The significance of anti-C sensitization in pregnancy

Cited by 11 publications

References 5 publications

Frequencies of maternal red blood cell alloantibodies in Port Harcourt, Nigeria

Frequencies of maternal red blood cell alloantibodies in Port Harcourt, Nigeria

Severe hydrops in the infant of a Rhesus D-positive mother due to anti-c antibodies diagnosed antenatally: a case report

Manejo de la embarazada con isoinmunización por anticuerpos irregulares

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