New Cases of Irregular Blood Group Antibodies Other Than Anti‐D in Pregnancy

Abstract

The frequency of irregular blood group antibodies detected for the first time in pregnant women during the period 1975-80 has been examined. Whereas Rh(D)-negative gravidae in Norway are examined immuno-hematologically three times during pregnancy, Rh(D)-positive women are tested once only, usually early in pregnancy. Nevertheless, about one-third of the new cases of immunization within the Rh system were found in the Rh-positive women. In the latter, anti-E and anti-c were the Rh antibodies most frequently encountered. Among other irregular antibodies which can cause hemolytic disease of the newborn (HDN), those of the Kell and Duffy systems are the ones second in frequency and clinical significance to the Rh antibodies. In the present series about 40% of the new cases of immunization within the Rh, Kell and Duffy systems were found in Rh-positive women. This proportion would undoubtedly have been greater if also the Rh-positive women had been retested for the presence of irregular blood group antibodies towards the end of the gestation. Such a retesting of Rh-positive gravidae is desirable both for a better prediction and early diagnosis of HDN and to facilitate the procurement of compatible blood if the woman should need an emergency blood transfusion.

Haemolytic Disease of the Newborn due to Anti-M

“…Over a 1-year period (1993), anti-M was the third most commonly encountered non-Rh antibody in antenatal patients, with an incidence of 2.0% for newly identified antibodies, and 1.33% of all samples with antibodies (excluding Rh anti bodies). These findings are similar to those of Komstad [6], as he chose not to include anti-Lewis antibodies in his sur vey and found anti-Kell to be the most frequently detected non-Rh antibody, with anti-M the second most frequent, followed by anti-Fya. Of the 29 anti-M antibodies detected during 1993 by Mersey Blood Services only the example of anti-M discussed here caused HDN, and so it would seem that while it is a common antibody, our data would endorse that it is usually a non-clinically important antibody.…”

“…Komstad [6] found anti-M to be the second commonest non-Rh antibody (after anti-Kell) in Norway between 1975 and 1980, though no cases of HDN occurred. Beal [7], performing a similar survey in South Australia between 1973 and 1978 found only one example of anti-M which was also not found to be associated with HDN.…”

Management of Pregnancies Complicated by Anti-c Isoimmunization

“…[1][2][3] The Rh antigen system is mainly composed of the antigens C, c, D, E, and e. The c antigen is a common cause of isoimmunization. 4 -14 Its relative ability to cause clinically significant hemolytic disease of the newborn, however, has been the focus of debate.…”

Anti-M antibodies as a cause of intrauterine fetal death and neonatal hyperbilirubinaemia

“…They are the most frequently encountered antibodies of the MNS blood group system 6. Anti-M antibodies are rarely associated with intrauterine deaths/non-immune hydrops or haemolytic disease of the newborn (HDN) 7. The index case is a rare association of anti-M antibodies with fetal hydrops and severe neonatal hyperbilirubinaemia and only few cases have been reported 2 3 8.…”