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- Title
Prevalence and Causes of Indirect Coombs Test Positivity in Multiparous Women.
- Authors
GÜLAY, Nurseli; ÖZCAN, Pınar; KUYUCU, Melda; KÜTÜK, Mehmet Serdar; TOLUK, Özlem
- Abstract
Introduction: RhD blood group incompatibility between the mother and fetus can sometimes lead to maternal alloimmunization. Maternal alloimmunization can occur in 2 ways: (1) following inappropriate blood transfusion and (2) following fetomaternal hemorrhage between the mother and the incompatible fetus. Fetomaternal bleeding can occur during labor, pregnancy, or delivery. Several predisposing factors cause fetomaternal hemorrhage. Spontaneous or induced abortion, amniocentesis, abdominal trauma, abruptio placenta, fetal death, multiple pregnancy, manual removal of the placenta, and cesarean section. Anti-D resulting from maternal alloimmunization can cross the placenta and attack fetal erythrocytes, which in worse scenarios can cause fetal anemia and ultimately death. The aim of this study was to determine the prevalence and causes of alloimmunization. Method: Between September 2022 and May 2023, multiparous and/or nulliparous pregnant women admitted to Bezmialem Vakıf University Hospital Obstetrics and Gynecology Outpatient Clinic were asked for indirect Coombs test (ICT) at the first antenatal visit. Age, blood type, gravida, parity, previous deliveries (normal spontaneous delivery and cesarean section), gestational week, singleton-twin status, previous abortion status, and history of blood transfusion were noted. Results: Between September 2022 and May 2023, 377 patients underwent ICT. Six patients were excluded because they were not pregnant. Seventeen of 371 patients tested positive (4.3%). The majority of the reasons were Rh incompatibility, but one patient was alloimmunize during blood transfusion (0.0026%). Fetal distress during transfusion resulted in cesarean section, and the fetus died. Conclusion: Maternal alloimmunization was mostly due to previous maternal blood transfusion. Sensitization may also occur during invasive procedures such as abortion, ectopic pregnancy, maternal trauma, and chorionic villus sampling. In our hospital, one patient was sensitized by blood transfusion.
- Subjects
BLOOD group incompatibility; ABORTION; MULTIPLE pregnancy; CESAREAN section; ABRUPTIO placentae; CHORIONIC villus sampling; PRENATAL diagnosis
- Publication
Bezmialem Science, 2024, Vol 13, pS21
- ISSN
2148-2373
- Publication type
Abstract