A Curious Case of Anti-D Antibody Titer

RhD alloimmunization remains a threat to 1% of the 10% of RhD-negative women in the United States who are giving birth to RhD-positive fetuses despite routine antenatal and postpartum administration of Rh oD immune globulin (RhIG). This report examines the clinical course of an RhD-negative woman wh...

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Bibliographic Details
Published in:Journal of midwifery & women's health 2009-11, Vol.54 (6), p.497-502
Main Authors: Hensley, Jennifer G., Coughlin, Katherine P., Klein, Laura L.
Format: Article
Language:English
Subjects:
Adult
Antenatal
Antibodies
Childbirth & labor
Erythroblastosis, Fetal - prevention & control
Female
Fetal Monitoring
Fetuses
Humans
Immunoglobulins
Isoantibodies - blood
Midwifery
Newborn babies
Nursing
Pregnancy
Pregnant women
Prenatal Care - standards
Rh Isoimmunization - diagnosis
Rh-Hr Blood-Group System - adverse effects
Rh-Hr Blood-Group System - blood
Rho(D) Immune Globulin
Surveillance
Women
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Summary:RhD alloimmunization remains a threat to 1% of the 10% of RhD-negative women in the United States who are giving birth to RhD-positive fetuses despite routine antenatal and postpartum administration of Rh oD immune globulin (RhIG). This report examines the clinical course of an RhD-negative woman who developed a high anti-D antibody titer during her pregnancy while carrying an RhD-positive female fetus yet had a negative antibody screen at the time she gave birth. Although she delivered a healthy newborn unaffected by hemolytic disease, subsequent pregnancies will be treated as though she is RhD alloimmunized. The discussion below includes possible causes for the abrupt rise in this woman's anti-D antibody titer, a review of the complex Rh system and cellular anamnestic response, and current fetal surveillance for hemolytic disease of the fetus and newborn.
ISSN:1526-9523
1542-2011
DOI:10.1016/j.jmwh.2009.08.006