Guideline for blood grouping and red cell antibody testing in pregnancy

White, Judith; Qureshi, Hira; Massey, Edwin; Needs, Malcolm; Byrne, Guerard W.; Daniels, Geoff; Allard, Shubha

doi:10.1111/tme.12299

Cited by 94 publications

(110 citation statements)

References 48 publications

(62 reference statements)

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“…Hence, if screening for FNAIT is implemented, measurements of HPA‐1a antibody levels could potentially be used for risk stratification of pregnancies and could guide the clinicians in order to avoid invasive procedures in pregnancies with low risk, and for planning the route of delivery and treatment of high‐risk pregnancies. Preliminary data suggest an antibody cut‐off of 3 IU/ml may potentially be used for risk assessment.…”

Section: Discussionmentioning

confidence: 99%

Maternal HPA‐1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia: a systematic review

Kjær

Bertrand²,

Bakchoul³

et al. 2018

Vox Sanguinis

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Background and Objectives In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA‐1a antibodies. HPA‐1a typing followed by screening for anti‐HPA‐1a antibodies in HPA‐1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA‐1a could be used to identify high‐risk pregnancies. Materials and Methods The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients. Results Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti‐HPA‐1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment. Conclusion HPA‐1a antibody level has the potential to predict the severity of FNAIT.

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Section: Discussionmentioning

confidence: 99%

Maternal HPA‐1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia: a systematic review

Kjær

Bertrand²,

Bakchoul³

et al. 2018

Vox Sanguinis

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“…Whilst there is no evidence to determine the required frequency for checking Hb in pregnancy, current good practice guidelines advise testing at the booking appointment and at 28 weeks [Pavord et al , ; Royal College of Obstetricians & Gynaecologists, ; White et al , ; National Institute for Health and Care Excellence (NICE) ]. New near‐patient test assays may allow more frequent testing in the future.…”

Section: Diagnosismentioning

confidence: 99%

UK guidelines on the management of iron deficiency in pregnancy

Daru²,

et al. 2019

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“…Recommendations Recommendation 28 : We recommend that all pregnant women should be ABO and D typed and screened for the presence of red cell antibodies early in pregnancy (at booking) and at 28 weeks gestation. In D‐negative women, the 28‐week sample should be taken before the administration of routine antenatal anti‐D Ig prophylaxis (1B) (White et al, ). Recommendation 29 : We recommend that RBC transfusion not be dictated by Hb levels alone (1C). Recommendation 30 : We recommend that transfusion be considered in non‐bleeding patients with an Hb <60 g L −1 , taking clinical signs and symptoms (risk of bleeding, cardiac compromise or symptoms requiring immediate attention) into consideration (1A). Recommendation 31 : In the absence of bleeding, should transfusion be deemed necessary, we recommend a single‐unit transfusion followed by clinical reassessment and/or Hb measurement to determine the need for further transfusion (1C). …”

Section: Post‐partum Anaemiamentioning

confidence: 99%