title: Quantification of anti-c in haemolytic disease of the newborn.
abstract: Anti-c is an important Rh antibody that causes haemolytic disease of the newborn (HDN). We have carried out a retrospective analysis of the clinical outcome of pregnancy in 120 mothers with anti-c. Of these, 100 gave birth to c-positive infants, of whom 14 had severe HDN requiring exchange transfusion. In all of these, the maternal level was 9.5 iu/ml or greater. Of the 29 women with anti-c levels of 9.5 iu/ml or above, in addition to the 14 with severely affected infants, 15 had infants requiring only phototherapy or no treatment. Our observations suggest that when the anti-c level is below 7.5 iu/ml, the fetus is unlikely to be seriously affected and invasive obstetric intervention is unnecessary. Of the 120 women studied, 50% had had a blood transfusion, in most cases for obstetric complications in a previous pregnancy. Although it was not possible to attribute alloimmunization to blood transfusion rather than previous pregnancy in any individual case, this observation points to the value of routine c typing as part of antenatal screening, so that c-negative blood can be selected.
authors.affiliation: North Western Regional Blood Transfusion Service, Plymouth Grove, Manchester, U.K.
authors.forename: C L
authors.initials: CL
authors.lastname: Kozlowski
authors.forename: D
authors.initials: D
authors.lastname: Lee
authors.forename: K H
authors.initials: KH
authors.lastname: Shwe
authors.forename: E M
authors.initials: EM
authors.lastname: Love
mesh_terms: D001663:Bilirubin / Q000097:blood; D001803:Blood Transfusion; D004899:Erythroblastosis, Fetal / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood*; D011247:Pregnancy; D011256:Pregnancy Outcome; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D007518:Isoantibodies; C051138:anti-c antibody; D001663:Bilirubin