Anti-erythrocyte antibodies in pregnant women

General Information

The purpose of routine antierythrocyte antibody testing during pregnancy is to:

• Identification of Rh-negative pregnant women who require prophylaxis with anti-Rh D immunoglobulin
• Identification of anti-erythrocyte antibodies
• Identification of pregnant women at risk of developing hemolytic disease of the fetus and newborn

When the mother and fetus have different Rhesus, the antigens on their blood cells are also different. This leads to sensitization of the Rhesus-negative mother's immune system and the production of IgG antibodies against the Rhesus-positive fetus' erythrocytes. These antibodies cross the placental barrier and cause erythrocyte destruction in the fetal blood (as a result of interaction with erythrocyte antigens).

Among the blood group antigens, the most common are the Rhesus antigens. There are several types of Rhesus antigens: C, c, D, E, e. The D antigen is the most common cause of maternal immune reactions. Although anti-D prophylaxis has significantly reduced the incidence of hemolytic disease of the fetus and newborn, this problem still remains.

The test detects antibodies to the following erythrocyte antigens:

D, C, Cw, E, c, e, K, k, Kpb, Fya, Fyb, Lua, Lub, Jka, Jkb, Jsb, M, N, S,s, Lea, Leb, P1, Xga, Coa.

According to the recommendations of clinical guidelines of obstetricians and gynecologists in Europe, Australia and North America, the antierythrocyte antibody test is first performed during the first obstetric visit in the first trimester. A repeat test is performed at 28 weeks. If a high antibody titer is observed at this time, then the test should be repeated every 4 weeks until delivery and 2 weeks before delivery.

Rhesus D negative pregnant women without anti-D isoimmunization will receive prophylactic treatment between the 28th and 30th weeks of pregnancy and within 72 hours of delivery (if the fetus is Rhesus D positive).

Patient preparation

No specific preparation is required.

A special form is filled out for the study, which must indicate whether the patient has received anti-D immunization in the last 8 weeks.

Material for examination: Venous blood