Prognostic Value of Quantitative Determination of Rhesus Antibody (Anti‐D) In Maternal Serum and Amniotic Fluid

Abstract

Quantitative determinations of anti‐D in sera and amniotic fluids were performed simultaneously in 63 pregnant Rh‐immunized women with Rh‐positive foetuses. It was demonstrated that the ratio of serum antibody to amniotic fluid antibody as a rule is the same. A quantitative analysis of the serum antibody enabled us to identify the foetuses with good prognoses. For ths remaining cases, it was possible to distinguish between moderate to severe cases and very severe cases of erythroblastosis by determining also the concentration or titre of amniotic fluid antibody. Where specimens were taken less than a fortnight before birth, the titre values alone made it possible to prognosticate correctly in 80% cases. Correlation of amniotic fluid antibody and bilirubin levels led to correct prognoses in 92% of the cases. With this background a plan for the control of pregnant Rh‐immunized women is suggested.

Amniotic Fluid Bilirubin as a Prognostic Indicator in Rhesus Isoimmunization

“…Since the first successful intrauterine transfusion in 1963 by Liley (16) the procedure has become an important part of the treatment of severe rhesus isoimmunization. Amniotic fluid examinations provide the major criteria, although other parameters such as past obstetric history, antibody level in serum and other factors are also helpful (13). In the great majority of the investigations the prognosis concerning the rhesus sensitized infant was reliable, but false predictions occurred ( I 1.…”