Kahar Manoj
Bhanumati Clinical Laboratory, G-19, Devdarshan Apartment, Beside Marolia Hospital, Station Road, Navsari, Gujarat 396445 India.
J Obstet Gynaecol India. 2018 Aug;68(4):300-305. doi: 10.1007/s13224-017-0984-5. Epub 2017 Mar 29.
Alloimmunisation due to irregular erythrocyte antibodies is a recognised cause of hemolytic disease of the fetus and newborn (HDFN). Prior knowledge of red cell alloimmunisation in pregnant females guides the obstetrician to monitor the foetus for HDFN and if required for appropriated intervention. As limited data are available on prevalence of red cell alloimmunisation in pregnant females in India, the current study was carried out to know the prevalence of red cell alloimmunisation in pregnant females coming at our laboratory.
Screening for irregular erythrocyte antibodies was performed in 1960 pregnant females after obtaining informed consent between June 2015 and June 2016. MatrixTM screening and identification reagent red cells from Tulip Diagnostics (P) Ltd were used, and column agglutination technique was employed as a method for the test.
Twenty antibodies (all of single specificity) were detected in 1960 samples giving a prevalence rate of alloimmunisation of 1.02%. Out of the 20 antibodies, 18 were identified to be anti-D, 1 was anti-c and 1 antibody was anti-H. The results obtained were then compared with those reported in the literature.
Red cell alloimmunisation is not uncommonly observed in pregnant females; the information gained can help the obstetrician to identify high-risk cases to timely start antenatal and post-natal treatment. Obstetricians should request screening for irregular red cell antibody desirably in all pregnant females; however, if limiting factors are there, it should be done at least in select group of pregnant females having bad obstetric history.
由不规则红细胞抗体引起的同种免疫是胎儿和新生儿溶血病(HDFN)的一个公认病因。了解怀孕女性红细胞同种免疫的既往情况有助于产科医生监测胎儿是否患有HDFN,并在需要时进行适当干预。由于印度怀孕女性红细胞同种免疫患病率的可用数据有限,因此开展了本研究,以了解前来我们实验室的怀孕女性中红细胞同种免疫的患病率。
在2015年6月至2016年6月期间,在获得知情同意后,对1960名怀孕女性进行了不规则红细胞抗体筛查。使用了来自Tulip Diagnostics (P) Ltd的MatrixTM筛查和鉴定试剂红细胞,并采用柱凝集技术作为检测方法。
在1960份样本中检测到20种抗体(均为单一特异性),同种免疫患病率为1.02%。在这20种抗体中,18种被鉴定为抗-D,1种为抗-c,1种抗体为抗-H。然后将获得的结果与文献报道的结果进行比较。
怀孕女性中红细胞同种免疫并不罕见;所获得的信息可帮助产科医生识别高危病例,以便及时开始产前和产后治疗。产科医生应尽可能要求对所有怀孕女性进行不规则红细胞抗体筛查;然而,如果存在限制因素,至少应对有不良产科病史的特定怀孕女性群体进行筛查。