The retrospective assessment of the pregnant women who had positive indirect antiglobulin test results and the evaluation of the antibodies identified in these patients during pregnancy

OBJECTIVE: In this study we aim to assess the incidence of alloimmunization against red blood cell surface antigens and to evaluate the clinical consequences in fetus and newborn resulting from the antibodies identified in the pregnant women with positive indirect antiglobulin test results. MATERIALS AND METHODS: 550 pregnant women applied to Gaziantep University Research and Training Hospital, Department of Obstetrics and Gynaecology between January 2011 and April 2014 and had indirect antiglobulin test (IAT) at Blood Bank. We identified antibodies in 45 of 550 pregnant women. In this retrospective study, we aim to assess the indirect antiglobulin test results of these 45 women and to evaluate their pregnancy outcomes. Frequency, percentage, mean and standart deviation were used as descriptive statistics. All statistical analysis was done by means of SPSSs (Statistical Package for Social Sciences) version 22.0 for Windows and p<0.005 was accepted as a statistically significant value. FINDINGS: Among 550 pregnant women, 52 (% 9.45) had positive indirect antiglobulin test results. The antibodies were identified in 45 of 52 pregnant women. No antibodies were identified in 7 cases. Among 45 cases who had antibodies, 37 had anti-D and 8 had non anti-D antibodies; anti-K, anti-Jka, anti-E/anti-K, anti-c and anti-C/anti-D respectively. Among 550 pregnant women, the incidence of alloimmunization against anti-D antigen was found 6.9 % while the incidence of alloimmunization against non anti-D antigens was found 1.45 %. Of these 45 pregnant women, 2 had fetal anemia and 4 had hydrops fetalis so these 6 patients received intrauterin fetal transfusion. 3 fetal death occured because of hydrops fetalis and 1 newborn died at the fifth day after birth. Exchange transfusion was performed for 7 newborns and phototherapy was performed for 21 newborns who had jaundice. CONCLUSION: The fact that the most common alloimmunization type was anti-D despite (anti-D) Rh immunoglobulin prophylaxis makes us think that there isn't enough administration for prophylaxis. This study also revealed that anti-K was the second most common antibody and anti-Jka was the third common antibody. It can be said that our country does not have the enough knowledge about (anti-D) Rh immunoglobulin prophylaxis. Moreover, detailed identification facilities for antibodies other than anti-D are not available in most of centers across our coutry. However, prospective large-scale studies on pregnant women need to be done in order to formulate guidelines and to define standarts for alloantibody screening and identification. KEY WORDS: Red cell alloimmunization, pregnancy, Rh (anti-D) immunoglobulin, blood groups, Hemolytic disease of the newborn (HDFN)