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Anti-E in pregnancy.

P Moran·S C Robson·M M Reid
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Abstract

Since the introduction of anti-Rhesus (Rh) D prophylaxis for RhD-negative women, other Rh and non-Rh red cell alloantibodies have become relatively more important and are now responsible for the greater proportion of haemolytic disease of the newborn. Anti-C and anti-E are the most commonly implicated non-D Rh antibodies in the pathogenesis of haemolytic disease of the newborn'. In 1977 Pepperell et al. reported the outcome of 44 women with anti-E. This is the only published series that investigates the implications of anti-E during pregnancy. The present report presents a retrospective study of the outcome of 122 pregnancies in which anti-E was the sole alloantibody detected.

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Erythroblastosis, FetalFemaleFetal BloodHemoglobinsHumansIsoantibodiesPregnancyPregnancy Complications, HematologicPregnancy OutcomeRetrospective StudiesJournal Article

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P Moran, S C Robson, M M Reid. 2000. Anti-E in pregnancy.. https://doi.org/10.1111/j.1471-0528.2000.tb11662.x

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PubMed2006

Anti-D in Rh positive pregnancies.

OBJECTIVE: The purpose of this study was to review the clinical outcomes of anti-D isoimmunization in a series of women who typed Rh positive or Rh weak positive. STUDY DESIGN: This was a review of The Ohio State University Medical Center Fetal Therapy Program Database. RESULTS: Of 1068 pregnancies affected by anti-D, 5 pregnancies (0.47%) occurred in 4 women between 1994 and 2004, who were serologically typed as Rh positive or Rh weak positive. All 5 pregnancies delivered at term. All newborns were confirmed affected either by a positive direct antiglobulin test (DAT) or were Rh positive. Newborns were not anemic at birth and subsequently did not require transfusion. No newborns were treated for jaundice. All newborns were discharged home with their mothers. CONCLUSION: Anti-D hemolytic disease of the fetus and newborn (HDFN) is a rare complication of Rh positive and Rh weak positive pregnancies. Although the potential for severe HDFN exists in this clinical scenario, our experience suggests that in Rh positive or Rh weak positive pregnancies with anti-D isoimmunization, clinical HDFN is mild. Nonetheless, Rh positive or Rh weak positive patients with anti-D should be monitored for potentially significant HDFN.

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PubMed2006

Hemolytic disease of the newborn due to anti-Di: a case study and review of the literature.

BACKGROUND: The severity of hemolytic disease of the newborn (HDN) due to Diego(b) (Di(b)) mismatch ranges from no symptoms to severe jaundice that requires exchange transfusion (ET). The clinical significance of anti-Di(b) is incompletely recognized. CASE REPORT: A male newborn, referred with jaundice, was revealed to have HDN due to Di(b) mismatch and was treated successfully with phototherapy and high-dose intravenous gamma globulin (IVGG). STUDY DESIGN AND METHODS: The literature of HDN caused by Di(b) mismatch was reviewed. The cases were classified into three groups according to their severity: the mildest needed no therapy (NO), the moderate group received phototherapy alone (PHOTO), and the most severe was treated with ET and/or high-dose IVGG therapy plus phototherapy (ET/IVGG). RESULTS: Among 27 cases of HDN due to Di(b) reported to date, 10, 6, and 11 cases required NO, PHOTO, and ET/IVGG, respectively. A significant correlation (p < 0.01) was found between the maternal anti-Di(b) titer and the severity of the disease when the ET/IVGG group was compared with the NO group. All mothers of the group that needed ET/IVGG had an anti-Di(b) titer of 64 or greater. CONCLUSION: A maternal high titer (> or =64) of anti-Di(b) is associated with a higher risk of severe hyperbilirubinemia for mismatched newborns.

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