Detection of high risk pregnancies with relation to ABO haemolytic disease of newborn

Usha, Kumari Krishnakumariamma Chakrapani; Sulochana, P V

doi:10.1007/bf02831348

Cited by 15 publications

(8 citation statements)

References 4 publications

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“…8 In an investigation carried out in Kerala, KC Usha and PV Sulochana had observed a direct correlation between high titres of IgM and IgG anti-A or anti-B levels and occurrence of ABO HDFN. 9 In our study titre of maternal antibody in ABO HDFN was positively correlated with grades of DAT, risk related to peak bilirubin levels, severity of disease and intensity of treatment and was negatively correlated with cord blood haemoglobin levels. A direct correlation between high titres of IgM and IgG anti-A or anti-B levels and ABO HDFN was observed by KC Usha and Sulochana.…”

Section: Resultssupporting

confidence: 51%

“…A direct correlation between high titres of IgM and IgG anti-A or anti-B levels and ABO HDFN was observed by KC Usha and Sulochana. 9 But in contrast to above-mentioned findings, Grundbacher et al and Marsh et al had opined that there existed a poor quantitative relationship between maternal antibody levels and the ensuing haemolytic process, which was attributed to variations in the strength and reactivity of ABO antigens among infants. 10,11 Chan Shu observed that there was no difference between group A and group B infants in the frequency and severity of haemolytic disease.…”

Section: Resultsmentioning

confidence: 91%

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Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Vilambil¹,

Dharmadas²,

Usha³

et al. 2017

jemds

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BACKGROUNDThe potency of anti-A and anti-B was determined by racial and environmental factors. With respect to ethnic groups, the prevalence and intensity of maternal-newborn ABO incompatibility varied in different populations. The aim of this study is to describe the immunological profile of ABO HDFN. Settings and Design-This was a descriptive study conducted in neonates with ABO HDFN. Research was conducted in Depts. of Transfusion Medicine and Neonatology division of Paediatrics in Govt. Medical College, Trivandrum. MATERIALS AND METHODSThose neonates who fulfilled the inclusion criteria were enrolled in this study. Demographic details, maternal details, bilirubin and haemoglobin levels were recorded. Investigations such as maternal blood grouping and antibody titration were done. In infant's blood sample direct antiglobulin test, blood grouping and elution was performed.Statistical Analysis-All statistical data were analysed using SPSS software version 16. RESULTSAmong mothers of infants with ABO HDFN 25 (22.7%) had a titre of 128, 34 (30.9%) had 256, 35 (31.8%) had 512 and 16 (14.6%) had 1024. Among 110 infants 34 (30.9%) were DAT positive, while the rest 76 (69.1%) were DAT negative. While DAT positive was graded 13 (11.8%) fell in grade 1, 16 (14.6%) in grade 2, 3 (2.7%) in grade 3 and 2 (1.8%) in grade 4 categories. Eluate from 59 (53.6%) of infants with ABO HDFN gave a positive result, while the rest 51 (46.4%) gave a negative result. Out of that 59 (53.6%) elution positive infants, 34 (30.9%) had a positive DAT and 25 (22.7%) had a negative DAT; 51 (46.4%) of infants were negative for both elution and DAT. CONCLUSIONMothers of infants with ABO HDFN had an antibody titre of 128 -1024. Almost one-third of infants were DAT positive and majority fell in grade 1 or 2. Eluate from half of infants gave a positive result.

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Section: Resultssupporting

confidence: 51%

Section: Resultsmentioning

confidence: 91%

Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Vilambil¹,

Dharmadas²,

Usha³

et al. 2017

jemds

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“…In another study by Usha and Sulochana. [6] including 100 antenatal O group mothers, ABO-HDFN was encountered in three neonates with high titers of both IgG and IgM anti-A and anti-B antibodies. In our three cases of ABO-HDFN, BET was required due to severe hyperbilirubinemia (>20 mg/dl) in the first 72 h of life.…”

Section: Discussionmentioning

confidence: 99%

Severe ABO hemolytic disease of fetus and newborn requiring blood exchange transfusion

Jain

Malhotra

Marwaha

et al. 2018

Asian J Transfus Sci

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ABO incompatibility and other alloantibodies have emerged as a significant cause of hemolytic disease of fetus and newborn (HDFN), leading to neonatal morbidity and mortality. We report three cases of severe ABO-HDFN where blood exchange transfusions (ETs) were required in neonates with hyperbilirubinemia. Blood grouping (ABO/RhD) was performed using conventional tube technique. The antibody screen was done using commercial three-cell panel (Bio-Rad ID-Diacell-I-II-III, Switzerland) by gel technique. Direct antiglobulin test (DAT) on neonatal sample and compatibility testing were also done by gel technique. Elution on DAT-positive sample was performed using “heat elution” method. All the three neonates were A RhD positive and were born to O RhD-positive mothers who were negative for antibody screen. Their DAT was positive (2+) and the elution of neonatal red cells yielded a positive reaction with A cells which was suggestive of anti-A antibody. The maternal anti-A (immunoglobulin G) antibody titers were high: 512 and 1024 (in two cases). The total serum bilirubin (mg/dl) of the three neonates was 22, 27, and 25 which came down significantly after they received ETs. Severe ABO-HDFN may occur in neonates born to mother with high titer ABO antibodies which can be effectively managed with ET.

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“…ABO incompatibility occurs in 15-20% of all pregnancies, which produces hemolytic disease in 10% of these cases [2]. High serum bilirubin levels due to hemolysis of red blood cells secondary to transplacental passage of antibodies lead to increased risk of bilirubin encephalopathy and kernicterus at bilirubin levels lower than that of jaundiced newborns without active hemolysis.…”

Section: Introductionmentioning

confidence: 99%

Single versus multiple dose intravenous immunoglobulin in combination with LED phototherapy in the treatment of ABO hemolytic disease in neonates

et al. 2011

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Intravenous immunoglobulin (IVIG) has been found to decrease hemolysis in neonatal jaundice due to blood group incompatibility, but a consensus on its usage has not been reached. We conducted a study to compare single versus multiple dose of IVIG in combination with light emitting diode (LED) phototherapy in patients with neonatal jaundice secondary to ABO blood incompatibility, and compared the efficacy of these treatments with that in a group of patients who received LED phototherapy solely. Thirty-nine term neonates with ABO blood group incompatibility were enrolled in the study. Group I received one dose of IVIG (1 g/kg) and LED phototherapy, and group II two doses of IVIG (1 g/kg) and LED phototherapy, whereas group III received LED phototherapy only. In group I, exchange transfusion was performed in one patient (6%) and in group II in one patient (10%). In the control group, none of the patients required exchange transfusion. Duration of LED phototherapy was 4.3 ± 0.7 days in group I + II (IVIG group), 3.9 ± 0.6 days in group III (P = 0.06). Lowest hematocrit level in group I + II was 35.0 ± 7.8 and group III was 38.9 ± 4.2, this was statistically significant (P = 0.034). IVIG therapy, single or multiple, did not affect exchange transfusion, need of erythrocyte transfusion and hospitalization time when used in combination with LED phototherapy in the treatment of ABO hemolytic jaundice in neonates.

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Detection of high risk pregnancies with relation to ABO haemolytic disease of newborn

Cited by 15 publications

References 4 publications

Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Immunohaematological Profile of Maternal Antibody-Mediated Abo Haemolytic Disease of Foetus and Newborn

Severe ABO hemolytic disease of fetus and newborn requiring blood exchange transfusion

Single versus multiple dose intravenous immunoglobulin in combination with LED phototherapy in the treatment of ABO hemolytic disease in neonates

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