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- Title
Clinical input of anti-D quantitation by continuous-flow analysis on autoanalyzer in the management of high-titer anti-D maternal alloimmunization.
- Authors
Toly‐Ndour, Cécile; Mourtada, Haifa; Huguet‐Jacquot, Stéphanie; Maisonneuve, Emeline; Friszer, Stéphanie; Pernot, Françoise; Thomas, Pauline; Jouannic, Jean‐Marie; Carbonne, Bruno; Cortey, Anne; Mailloux, Agnès; Toly-Ndour, Cécile; Huguet-Jacquot, Stéphanie; Jouannic, Jean-Marie
- Abstract
<bold>Background: </bold>In addition to titration by indirect antiglobulin test most widely used, anti-D quantitation by continuous-flow analysis (CFA) may be performed to assess severity of maternal immunization. Only five studies have reported its added value in the management of pregnancies complicated by anti-D immunization.<bold>Study Design and Methods: </bold>A retrospective study of 74 severe anti-D-immunized pregnancies was conducted from January 1, 2013, to December 31, 2014, in the Trousseau Hospital in Paris (France). Concentration of maternal anti-D was measured by titration and by CFA two-stages method (2SM; total amount of anti-D) and one-stage method (1SM; high-affinity IgG1 anti-D). These biologic data were analyzed according to the severity of the hemolytic disease of the fetus and the newborn.<bold>Results: </bold>The value of 5 IU anti-D/mL in maternal serum is validated as a threshold to trigger ultrasonographic and Doppler fetal close follow-up. A high 1SM/2SM ratio was associated with a higher risk of intrauterine transfusion (IUT). For pregnancies requiring IUT and without increasing titer, maternal 1SM anti-D concentration tends to correlate with the precocity of fetal anemia. In the "without-IUT" group 1SM and 2SM anti-D concentrations correlate significantly with cord bilirubin levels of the newborn at birth.<bold>Conclusion: </bold>Altogether our results underline the importance of anti-D quantitation by CFA to optimize the management of anti-D-alloimmunized pregnancies.
- Subjects
FRANCE; MATERNALLY acquired immunity; ALLOIMMUNITY; IMMUNE response; AUTOANALYZERS; IMMUNOGLOBULIN G; BILIRUBIN; INTRAUTERINE blood transfusion; AUTOIMMUNE hemolytic anemia; IMMUNOGLOBULINS; RH factor; RETROSPECTIVE studies; RH isoimmunization
- Publication
Transfusion, 2018, Vol 58, Issue 2, p294
- ISSN
0041-1132
- Publication type
journal article
- DOI
10.1111/trf.14406