Current clinical management of anti-Kell alloimmunization in pregnancy.
OBJECTIVE
Few reports have been published of the current clinical management of anti-Kell alloimmunization in pregnancy; its low frequency of occurrence means that the few long series published have covered very ample time periods in which different kinds of clinical management have overlapped. The objective of the present paper is to present our experience in the current clinical management of pregnant women who are positive for the anti-Kell antibody.


METHODS
A retrospective analysis was carried out of the case histories of pregnant women who were alloimmunized for the Kell antigen and who were studied and/or treated at the Department of Fetal Medicine in the Virgen de las Nieves University Hospital in Granada (Spain), between 2000 and 2004. The clinical management included the basal measurement of the titre of antibodies, the identification of the paternal phenotype (and that of the fetus, if necessary), the ultrasonographic monitoring of the fetus to detect signs of anaemia, sampling of fetal blood by cordocentesis when fetal anaemia was suspected, and fetal intravascular transfusion when necessary.


RESULTS
Of the 10 pregnancies with anti-Kell antibodies, The Kell antigen was confirmed in the fetus in three cases, in all of which moderate to severe fetal anaemia developed, requiring fetal intravascular transfusions. Although one of the fetus developed antenatal hydrops, a good perinatal result was advised.


CONCLUSIONS
The current approach to anti-Kell alloimmunization enables pregnant women who have Kell-positive fetuses to be treated successfully.
Santiago
Juan C
JC
Unidad de Medicina Fetal, Servicio de Obstetricia y Ginecología del Hospital Universitario V. De las Nieves, 180-Granada, Spain.
Ramos-Corpas
Domingo
D
Oyonarte
Salvador
S
Montoya
Francisco
F
D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000276:immunology / Q000628:therapy*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D005319:Fetal Hemoglobin / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000097:blood; D007626:Kell Blood-Group System / Q000276:immunology*; D011247:Pregnancy; D012189:Retrospective Studies
D007518:Isoantibodies; D007626:Kell Blood-Group System; D005319:Fetal Hemoglobin