Monitoring the clearance of fetal RhD-positive red cells in FMH following RhD immunoglobulin administration.
Anti-RhD immunoglobulin was administered to RhD-negative women based on estimates of fetal bleed size obtained using a direct immunofluorescence flow cytometric technique employing a FITC-conjugated monoclonal human anti-D (BRAD 3). The effectiveness of the dose administered was assessed by (i) measuring the fraction of RhD-positive fetal cells in the maternal circulation at d0, and between d2 and d10 post RhD Ig administration, (ii) quantifying the amount of anti-D detectable in maternal plasma following RhD Ig injection in the perinatal period and (iii) assessing maternal serum for the presence of immune anti-D in follow-up samples taken 3 months to 3 years after delivery. Fifty-four women were assessed, 29 having fetal bleeds in excess of 4 mL. Follow-up samples were received from 20/29 mothers after RhD Ig administration; 43-99% and 69-99% of fetal cells had been cleared by d2/3 and d5/6, respectively, in 14/20 mothers, whereas less than 50% had been cleared in the remaining mothers. Long-term follow-up samples were obtained from eight of the 29 mothers (four with bleeds >/=20 mL, two with bleeds >95 mL): none had detectable anti-D in the serum 4 months to 3 years after delivery despite the persistence of up to 36% fetal RhD-positive cells in the maternal circulation six days after delivery.
Lubenko
A
A
National Blood Service - Leeds Blood Centre, West Yorkshire, UK.
Williams
M
M
Johnson
A
A
Pluck
J
J
Armstrong
D
D
MacLennan
S
S
D004912:Erythrocytes / Q000276:immunology*; D005260:Female; D005331:Fetomaternal Transfusion / Q000188:drug therapy* / Q000276:immunology; D005434:Flow Cytometry; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007136:Immunoglobulins / Q000008:administration & dosage*; D007518:Isoantibodies / Q000097:blood; D049590:Postpartum Period; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000188:drug therapy* / Q000276:immunology; D012203:Rh Isoimmunization / Q000517:prevention & control / Q000628:therapy; D012204:Rh-Hr Blood-Group System / Q000276:immunology*; D013997:Time Factors
D007136:Immunoglobulins; D007518:Isoantibodies; D012204:Rh-Hr Blood-Group System