title: Mononuclear phagocyte assays, autoanalyzer quantitation and IgG subclasses of maternal anti-RhD in the prediction of the severity of haemolytic disease in the fetus before 32 weeks gestation.
abstract: In 40 cases of haemolytic disease of the fetus due to RhD immunization where the fetus required intrauterine transfusion, fetal packed cell volume was compared with the following parameters of maternal anti-D: (a) concentration, (b) IgG subclass, (c) activity in a macrophage binding assay, and (d) activity in a monocyte antibody-dependent cell mediated cytotoxicity (ADCC) assay. The anti-D concentration exceeded 4 iu/ml in all cases, correctly indicating the risk of haemolytic disease. A relationship between IgG subclass composition of the anti-D and severity of anaemia was not observed; IgG1, IgG3 and IgG1 + 3 antibodies were all detected. The ADCC assay gave the best correlation between assay results and fetal packed cell volume; high results correctly indicated fetal anaemia in 95% of cases. Macrophage binding assay results were only considered as high in 70% of cases. Overall, these results indicate that serological tests and bioassays in highly immunized mothers may not generate any information that proves more useful than ultrasonography and their previous obstetric history.
authors.affiliation: North London Blood Transfusion Centre, Colindale.
authors.forename: S F
authors.initials: SF
authors.lastname: Garner
authors.forename: E
authors.initials: E
authors.lastname: Wiener
authors.forename: M
authors.initials: M
authors.lastname: Contreras
authors.forename: U
authors.initials: U
authors.lastname: Nicolini
authors.forename: N
authors.initials: N
authors.lastname: Kochenour
authors.forename: E
authors.initials: E
authors.lastname: Letsky
authors.forename: C H
authors.initials: CH
authors.lastname: Rodeck
mesh_terms: D000920:Antibody-Dependent Cell Cytotoxicity / Q000276:immunology; D004899:Erythroblastosis, Fetal / Q000175:diagnosis*; D004912:Erythrocytes / Q000276:immunology; D005260:Female; D005865:Gestational Age; D006400:Hematocrit; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis*; D007231:Infant, Newborn; D007518:Isoantibodies / Q000032:analysis*; D008264:Macrophages / Q000276:immunology; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012204:Rh-Hr Blood-Group System / Q000276:immunology*
chemical_list: D007074:Immunoglobulin G; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System