Prevention of Hemolytic Disease of the Newborn in Rh Negative Mother
Keywords:
Rh negative mother, Anti-D, HDNAbstract
Abstract : Department of Transfusion Medicine and Department of Obstetrics and Gynecology have performed ABO, Rh (D antigen), Du test, and screening in 15,862 pregnant women who attended antenatal clinic at Siriraj Hospital during September 1996 and December 1997. Antibody identification and titration were also performed in 3 women whose sera were positive for antibody screening. It was found that 47 pregnant women were Rh negative (0.3%), 44 in 47 cases of Rh negative women had no anti-D in their serum and 3 in 47 cases had anti-D titer of 64,128 and 512 respectively. Rh negative women who had no anti-D received Rh immunoglobulin at 28 weeks' gestation and after delivery of Rh positive babies. At Department of Transfusion Medicine, we found that about 80% of Rh-HDN, the mother had anti-D titer of 512 and every baby received exchange transfusion. About 20% of cases with matermal anti-D titer less than 512 did not need exchange transfusion. Therefore, Rh (D) typing in every pregnant woman is a good starting point to prevent anti-D HDN in Rh negative mother.
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