title: Predicting the severity of haemolytic disease of the newborn: an assessment of the clinical usefulness of the chemiluminescence test.
abstract: The ability of the chemiluminescence test (CLT) to predict the severity of haemolytic disease of the newborn (HDN) was determined in 80 alloimmunized pregnant women who delivered antigen-positive babies. In 54 cases of alloimmunization to D, results from the CLT showed better correlation with fetal outcome than anti-D concentration measured by AutoAnalyzer (r = 0.70 and 0.36 respectively). Results from the CLT permitted a threshold level of antibody activity (30%) below which 15/20 babies were unaffected or had mild disease, and only one required transfusion therapy in utero. CLT results above 30% were associated with moderate or severe disease in all cases. Results from the AutoAnalyzer proved a less reliable predictor of disease severity; three women with anti-D levels > 20 iu/ml delivered unaffected babies, and two women with anti-D levels < 10 iu/ml delivered babies who had required transfusion in utero. The clinical usefulness of the CLT derives from the possibility of avoiding invasive monitoring procedures in women with high levels of anti-D which is relatively non-functional.
authors.affiliation: International Blood Group Reference Laboratory, Bristol.
authors.forename: A L
authors.initials: AL
authors.lastname: Noble
authors.forename: G D
authors.initials: GD
authors.lastname: Poole
authors.forename: N
authors.initials: N
authors.lastname: Anderson
authors.forename: G F
authors.initials: GF
authors.lastname: Lucas
authors.forename: A G
authors.initials: AG
authors.lastname: Hadley
mesh_terms: D004899:Erythroblastosis, Fetal / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008163:Luminescent Measurements; D011237:Predictive Value of Tests; D011247:Pregnancy; D011296:Prenatal Diagnosis / Q000379:methods*; D012203:Rh Isoimmunization / Q000097:blood; D018029:Rho(D) Immune Globulin / Q000097:blood
chemical_list: D018029:Rho(D) Immune Globulin