Evaluating automated titre score as an alternative to continuous flow analysis for the prediction of passive <scp>anti‐D</scp> in pregnancy

Evans, Michelle L.; Holmes, Benjamin; Dowling, Kerry; Lofting, Tracey; Barnett, M; Heydon, Nicolette; Clarke, T K; Hall, Christopher; Surmann, Eva-Maria; Callsen, Sophie C. I.; Malomgre, Wim

doi:10.1111/tme.12743

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Pitfalls of mistaking passive anti-D for active immunization can be avoided by obtaining a history and performing an anti-D titer. 15 In summary, we decided to treat the current patient as D+ for transfusion purposes and recommended against RhIG administration during pregnancy and after the birth of the D+ baby boy.…”

Section: Discussionmentioning

confidence: 99%

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele

et al. 2021

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D-red blood cells (RBCs), always in short supply, and Rh immune globulin (RhIG) are not needed for patient care if D+ RBCs can safely be transfused. According to a recent work group recommendation, patients with the RHD*weak D type 4.0 allele can be considered D+. We report an African American woman who presented for delivery at the end of the third trimester, at which time anti-U and a serologic weak D phenotype were recognized, requiring U-, D-RBC units. We obtained 3 U-RBC units, including 1 D-unit. Later, the RHD*weak D type 4.0 allele was determined by RHD genotyping, only 6 days before delivery. The patient had an uneventful vaginal delivery of a D+ baby. No transfusion was needed for mother or baby. In this case, a pregnant woman with the RHD*weak D type 4.0 allele can safely be managed as D+, relaxing the unnecessary D-restriction for the limited U-RBC supply. The procured U-, D-RBC unit was frozen with 14 days of shelf-life remaining. To conserve D-RBC units, not limited to U-, for patients with a definite need, we recommend molecular analysis of a serologic weak D phenotype before a transfusion becomes imminent. The best time to resolve a serologic weak D phenotype with RHD genotyping is early in a pregnancy. Immunohematology 2021;37:1-4.

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Section: Discussionmentioning

confidence: 99%

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele

et al. 2021

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Maternal red blood cell alloimmunization prevalence in the United States

Sugrue,

Moise,

Federspiel

et al. 2024

Blood Advances

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Hemolytic disease of fetus and newborn (HDFN) is a life-threatening disease mediated by maternal alloimmunization to red blood cell (RBC) antigens. Studies of maternal alloimmunization prevalence in the United States (U.S.) lack national data. This study describes prevalence and trends in alloimmunization in pregnancy in the U.S. RBC antibodies (abs) were identified in a large, nationwide, commercial laboratory database from 2010-2021. The cohort comprised pregnancies for which the year of lab collection and patient's state of residence were available. Data were normalized based on U.S. Centers for Disease Control and Prevention estimates of live births and weighted by year and U.S. Census Division. Cochrane-Armitage tests assessed temporal trends of alloimmunization. Of 9,876,196 pregnancies, 1.5% (147,262) screened positive for RBC abs, corresponding to an estimated prevalence of 1,518/100,000 pregnancies. Of identified RBC abs, anti-D comprised 64.1% (586/100,000 pregnancies). Prevalence of other high-risk RBC abs for HDFN included anti-K (68/100,000) and anti-c (29/100,000). Incidence of all three high-risk abs increased from 2010-21 (all p<0.001). Among almost 10 million pregnancies in the US, comprising an estimated 14.4% of all pregnancies, 1.5% screened positive for RBC abs. Almost three-quarters (74.3%; 683/100,000) of RBC abs identified were high-risk for HDFN. Though prevalence of anti-D is difficult to interpret without the ability to distinguish alloimmunization from passive immunity, it remains problematic in HDFN, ranking second only to anti-K in critical titers. Given the sequelae of HDFN, new initiatives are required to reduce the incidence of alloimmunization in patients of reproductive potential.

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Evaluating automated titre score as an alternative to continuous flow analysis for the prediction of passive anti‐D in pregnancy

Cited by 2 publications

References 9 publications

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele

Maternal red blood cell alloimmunization prevalence in the United States

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Evaluating automated titre score as an alternative to continuous flow analysis for the prediction of passive anti‐D in pregnancy

Cited by 2 publications

References 9 publications

Transfusion support during childbirth for a woman with anti-U and the RHD*weak D type 4.0 allele

Transfusion support during childbirth for a woman with anti-U and the RHD*weak D type 4.0 allele

Maternal red blood cell alloimmunization prevalence in the United States

Contact Info

Product

Resources

About

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele

Transfusion support during childbirth for a woman with anti-U and the RHDweak D type 4.0* allele