title: The ability of the chemiluminescence test to predict clinical outcome and the necessity for amniocenteses in pregnancies at risk of haemolytic disease of the newborn.
abstract: The chemiluminescence test measures the ability of anti-D to sensitise red cells for recognition by monocytes. It predicts clinical outcome in haemolytic disease of the newborn with greater precision than quantification of anti-D levels by AutoAnalyzer. However, whether or not the chemiluminescence test can, or should, affect clinical management is not clear. Of 56 alloimmunised women referred to a single fetal medicine unit, 30 underwent a total 63 amniocenteses to establish the extent of fetal haemolysis. Overall, chemiluminescence test results were a better predictor of amniocenteses with elevated bilirubin levels than the AutoAnalyzer (P < 0.01). Chemiluminescence results > 30% were always associated with elevated bilirubin levels. The chemiluminescence test might be used to prompt the direct evaluation of fetal haemolysis in patients with borderline levels of anti-D (5-15 IU/mL). However, the ability of the test to predict amniocenteses with normal bilirubin levels was less clear.
authors.affiliation: International Blood Group Reference Laboratory, Bristol.
authors.forename: A G
authors.initials: AG
authors.lastname: Hadley
authors.forename: A
authors.initials: A
authors.lastname: Wilkes
authors.forename: J
authors.initials: J
authors.lastname: Goodrick
authors.forename: D
authors.initials: D
authors.lastname: Penman
authors.forename: P
authors.initials: P
authors.lastname: Soothill
authors.forename: G
authors.initials: G
authors.lastname: Lucas
mesh_terms: D000649:Amniocentesis; D004899:Erythroblastosis, Fetal / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008163:Luminescent Measurements; D011237:Predictive Value of Tests; D011247:Pregnancy; D012307:Risk Factors; D012680:Sensitivity and Specificity