Management of anti-Jka alloimmunization.
OBJECTIVE
To determine whether prenatal management using guidelines established for anti-D is applicable to anti-Jka.


METHODS
A computerized database containing the records of all alloimmunized pregnancies at The Ohio State University Medical Center with due dates from 1959 to 2008 was used to identify pregnancies affected only by anti-Jka. Only cases with evidence that the newborn was Jka antigen positive were included.


RESULTS
Twenty affected pregnancies met inclusion criteria. Of those, 16 pregnancies required monitoring with serum titers only and 4 were followed with more diagnostic tests as recommended during that time period. One pregnancy with the highest titer of 32 and elevated middle cerebral artery peak systolic velocity (MCA PSV) required 4 intrauterine transfusions for fetal anemia. Another pregnancy with a titer of 32 had an infant who required phototherapy for hemolytic disease of the fetus/newborn (HDFN), with a hemoglobin value of 15.9 g/dL. None of the other 18 infants required any therapy for HDFN.


CONCLUSIONS
Our case series identified severe disease in 1 of 20 pregnancies from anti-Jka using maternal antibody titer and MCA PSV. Criteria used for monitoring RhD alloimmunization were effective in detecting severe HDFN resulting from to anti-Jka.
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, The Ohio State University, Columbus, Ohio, USA.
Albert
A
Franco
Karen
K
Rossi
Dave
D
Krugh
Richard
R
O'Shaughnessy
D000740:Anemia / Q000175:diagnosis / Q000628:therapy*; D001783:Blood Flow Velocity; D001789:Blood Group Antigens / Q000276:immunology*; D001787:Blood Group Incompatibility / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D005315:Fetal Diseases / Q000175:diagnosis / Q000628:therapy; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007231:Infant, Newborn; D007518:Isoantibodies / Q000032:analysis*; D020768:Middle Cerebral Artery / Q000502:physiology; D009820:Ohio; D011247:Pregnancy; D011295:Prenatal Care; D012189:Retrospective Studies; D012307:Risk Factors
D001789:Blood Group Antigens; D006454:Hemoglobins; D007518:Isoantibodies