title: Clinical value of an antibody-dependent cell-mediated cytotoxicity assay in the management of Rh D alloimmunization.
abstract: OBJECTIVE
  The aim of this study was to evaluate the clinical value of an antibody-dependent cell-mediated cytotoxicity assay relative to the indirect antiglobulin test titer in the management of Rh D-alloimmunized pregnancies.
  
  
  METHODS
  Data from 172 Rh D-alloimmunized pregnancies were analyzed retrospectively. The accuracies of the highest antibody titer and of the highest antibody-dependent cell-mediated cytotoxicity assay result during pregnancy to predict fetal and neonatal Rh disease, defined as the need for intrauterine (n = 30) or neonatal (n = 37) blood transfusion, respectively, were assessed.
  
  
  RESULTS
  At different cutoff levels with equal sensitivities the antibody-dependent cell-mediated cytotoxicity assay consistently showed a higher specificity than the antibody titer for the prediction of fetal disease. No difference was found between the receiver operating characteristic curves of the 2 tests for the prediction of neonatal disease.
  
  
  CONCLUSIONS
  Selection of patients for referral and invasive testing for Rh D alloimmunization may be improved with the use of an antibody-dependent cell-mediated cytotoxicity assay.
authors: Division of Fetal Diagnosis and Treatment, Department of Obstetrics, Leiden University Medical Center, The Netherlands.
authors: D
authors: D
authors: Oepkes
authors: I L
authors: IL
authors: van Kamp
authors: M J
authors: MJ
authors: Simon
authors: J
authors: J
authors: Mesman
authors: M A
authors: MA
authors: Overbeeke
authors: H H
authors: HH
authors: Kanhai
mesh_terms: D000920:Antibody-Dependent Cell Cytotoxicity / Q000276:immunology*; D003298:Coombs Test; D003601:Cytotoxicity Tests, Immunologic / Q000379:methods; D005260:Female; D005312:Fetal Blood; D006400:Hematocrit; D006801:Humans; D007231:Infant, Newborn; D011237:Predictive Value of Tests; D011247:Pregnancy; D011256:Pregnancy Outcome; D012372:ROC Curve; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000097:blood / Q000175:diagnosis / Q000276:immunology*; D012204:Rh-Hr Blood-Group System / Q000097:blood / Q000276:immunology; D018029:Rho(D) Immune Globulin / Q000276:immunology; D018709:Statistics, Nonparametric
chemical_list: D012204:Rh-Hr Blood-Group System; D018029:Rho(D) Immune Globulin