Am J Perinatol 2006; 23(3): 189-192
DOI: 10.1055/s-2006-934092
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Prevalence of New Maternal Alloantibodies After Intrauterine Transfusion for Severe Rhesus Disease

William J. Watson1 , Joseph R. Wax2 , Richard C. Miller3 , Brian C. Brost1
  • 1Mayo Clinic, Rochester, Minnesota
  • 2Maine Medical Center, Portland, Maine
  • 3Saint Barnabus Medical Center, Livingston, New Jersey
Further Information

Publication History

Publication Date:
29 March 2006 (online)

ABSTRACT

Limited information is published on the frequency of new maternal alloantibodies found in patients treated for isoimmunization. The purpose of this study was to determine the prevalence of additional maternal red cell alloantibodies, found after the initiation of treatment for Rhesus (Rh) disease. A retrospective review of all patients treated for severe Rh disease was undertaken. Rh disease requiring intrauterine blood transfusion was defined as severe. Gravidas with alloantibodies in addition to Rh were included, but those without Rh antibodies were excluded. New alloantibodies were defined as antibodies absent in previous pregnancies and on initial pregnancy screening, and found after the onset of invasive treatment. There were a total of 84 intrauterine blood transfusions performed in 31 gravidas with severe Rh disease. Seven patients (23%) were found to develop additional red cell alloantibodies after treatment during the pregnancy. Induction of additional maternal red cell alloantibodies after treatment for severe Rh disease is relatively common. This may have significant implications for future pregnancies in this high-risk population.

REFERENCES

  • 1 Moise K J. Management of rhesus alloimmunization in pregnancy.  Obstet Gynecol. 2002;  100 600-611
  • 2 Vietor H E, Kanhai H H, Brand A. Induction of additional red cell alloantibodies after intrauterine transfusions.  Transfusion. 1994;  970-974
  • 3 Hoch H, Giers G, Bald R, Hanfland P. Spezifitat und Haufidkeit erythrozytarer Antikorper bei Schwangeren mit intrauterinen Tyransfusionen infolge fetaler Erythroblastose.  Beitr Infiisionsther. 1992;  30 439-442
  • 4 Nicolini U, Kockenour N K, Greco P et al.. Consequences of fetomaternal hemorrhage after intrauterine transfusion.  BMJ. 1988;  297 1379-1381
  • 5 Poland G A, Jacobson R M, Schaid D, Moore S B, Jacobsen S J. The association between HLA class I alleles and measles vaccine-induced antibody response: evidence of a significant association.  Vaccine. 1998;  16 1869-1871
  • 6 Spong C Y, Porter A E, Queenan J T. Management of isoimmunization in the presence of multiple maternal antibodies.  Am J Obstet Gynecol. 2001;  185 481-484

William J WatsonM.D 

Department of Obstetrics and Gynecology, Maternal Fetal Medicine, Charlton 3B, Mayo Clinic

200 First Street/SW, Rochester, MN 55905