Prevention and diagnostics of haemolytic disease of the fetus and newborn

Haemolytic disease of the newborn (HDN), also known as haemolytic disease of the fetus and newborn (HDFN), develops in the fetus when erythrocyte alloantibodies produced by the mother pass through the placenta. Severe form of HDFN is mainly caused by anti-D antibodies, but it can also be caused by many other types of antibodies, most often by anti-Kell (anti-K), anti-c, anti-E in anti-C. In order to prevent sensitisation to erythrocyte antigens, every pregnant woman is tested for blood group AB0, D, K and for irregular antibodies (IAT–indirect antiglobulin test). For D-negative women IAT is repeated in the 28th week of pregnancy, followed by an injection of anti-D immnunoglobulin (Ig anti-D) when indicated. At the Blood Transfusion Centre of Slovenia, we have recently started to determine the fetal D status from a maternal blood sample in order to avoid the unnecessary application of Ig anti-D to women bearing Dnegative fetuses.

[1]  V. Stefanovic,et al.  Severe hemolytic disease of fetus and newborn caused by red blood cell antibodies undetected at first‐trimester screening (CME) , 2011, Transfusion.

[2]  W. Judd.  When should tests for unexpected antibodies be done during pregnancy? , 2011, Transfusion.

[3]  F. Walther,et al.  Exchange transfusions and top‐up transfusions in neonates with Kell haemolytic disease compared to Rh D haemolytic disease , 2011, Vox sanguinis.

[4]  K. Hue‐Roye,et al.  Possible suppression of fetal erythropoiesis by the Kell blood group antibody anti-Kpa , 2011, Immunohematology.

[5]  E. Gündüz,et al.  Incidence of red-cell alloimmunization due to non-anti-D antibodies during pregnancy: an experience from Turkey. , 2010, Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis.

[6]  N. Marwaha,et al.  Hemolytic disease of newborn due to anti-Jk b in a woman with high risk pregnancy. , 2010, Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis.

[7]  A. Lazarus,et al.  Mechanisms of anti-D action in the prevention of hemolytic disease of the fetus and newborn: what can we learn from rodent models? , 2009, Current opinion in hematology.

[8]  P. Soothill,et al.  Noninvasive approach for the management of hemolytic disease of the fetus , 2009, Expert review of hematology.

[9]  J. Wray,et al.  Guideline for blood grouping and antibody testing in pregnancy , 2007, Transfusion medicine.

[10]  B. Kumpel.  On the immunologic basis of Rh immune globulin (anti‐D) prophylaxis , 2006, Transfusion.

[11]  C. Gassner,et al.  Pancytopenia Due to Suppressed Hematopoiesis in a Case of Fatal Hemolytic Disease of the Newborn Associated With Anti-K Supported by Molecular K1 Typing , 2004, Journal of pediatric hematology/oncology.

[12]  G. Daniels,et al.  Causes of fetal anemia in hemolytic disease due to anti‐K , 2003, Transfusion.

[13]  J. Sulkes,et al.  Maternal anti-D prophylaxis during pregnancy does not cause neonatal haemolysis , 2001, Archives of disease in childhood. Fetal and neonatal edition.

[14]  S. Robson,et al.  Anti‐E in pregnancy , 2000, BJOG : an international journal of obstetrics and gynaecology.

[15]  K. Moise.  Non-anti-D antibodies in red-cell alloimmunization. , 2000, European journal of obstetrics, gynecology, and reproductive biology.

[16]  K. Geissler,et al.  Kell is not restricted to the erythropoietic lineage but is also expressed on myeloid progenitor cells , 2000, British journal of haematology.

[17]  H. Nagaraja,et al.  Management of pregnancies complicated by anti-Kell isoimmunization. , 1999, Obstetrics and gynecology.

[18]  M. Goodrick,et al.  Haemolytic disease of the fetus and newborn due to anti‐Fya and the potential clinical value of Duffy genotyping in pregnancies at risk , 1997, Transfusion medicine.

[19]  I. Sargent,et al.  Presence of fetal DNA in maternal plasma and serum , 1997, The Lancet.

[20]  E. Love,et al.  Quantification of anti‐c in haemolytic disease of the newborn , 1995, Transfusion medicine.

[21]  K. Stuhlmeier,et al.  Comparison of PCR methods for detecting fetal RhDin maternal plasma , 2009, Journal of clinical laboratory analysis.