The significance of anti-Kell sensitization in pregnancy.
In a 10-year period, 407 of 350,000 pregnancies showed maternal anti-Kell allo-immunization, i.e., an incidence of 1.16 per 1000 pregnancies. About 88% of Kell immunized women gave a history of previous transfusion. There were 51 pregnancies with Kell positive partners (all Kk) resulting in 10 Kell positive babies, of whom six had a positive direct antiglobulin test (DAGT). There were two stillbirths due to haemolytic disease of the newborn, when the maternal anti-Kell titres were 1/256. One baby was severely anaemic and given a top-up transfusion, and two babies were jaundiced and given phototherapy. A policy for management of Kell sensitized pregnancies is outlined, based upon maternal anti-Kell titre and where appropriate fetal blood sampling.
Mayne
K M
KM
Regional Blood Transfusion Centre, John Radcliffe Hospital, Oxford.
Bowell
P J
PJ
Pratt
G A
GA
D000649:Amniocentesis / Q000009:adverse effects; D001787:Blood Group Incompatibility / Q000276:immunology*; D004899:Erythroblastosis, Fetal / Q000209:etiology*; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D007114:Immunization; D007231:Infant, Newborn; D007518:Isoantibodies / Q000032:analysis; D007626:Kell Blood-Group System / Q000276:immunology*; D008431:Maternal-Fetal Exchange; D011247:Pregnancy / Q000276:immunology*; D012189:Retrospective Studies
D007518:Isoantibodies; D007626:Kell Blood-Group System