The Clinical Significance of Prenatal Antibody Screening Test

Chung, Hwa Ryung; Park, Yun Mi

Abstract

BACKGROUND: It is recommended that ABO, Rh typing and unexpected antibody screening should be tested during pregnancy in order to prevent hemolytic disease of the newborn (HDN). However, it is unclear that a routine prenatal antibody screening test predicts the occurrence of HDN. We performed a retrospective study to determine the frequency of unexpected antibody during pregnancy, antibody specificity, and the usefulness of prenatal antibody screening as a predictor of HDN.
METHODS
All 6,293 prenatal antibody screening were tested at Eulji hospital from April 1997 to December 2002. The results of antibody screening and identification test were reviewed in laboratory sheet. The past transfusion and pregnant history and postnatal HDN evidence were reviewed in pregnant women with positive antibody screening. A commercial two cell panel, Selectogen I, II, and panel cell (Ortho Diagnostic Systems Inc., Raritan, USA) were used with tube method until March 1999. In April 1999, reagent cells were changed to a gel agglutination test with ID-Diacell I, II and ID-Dia Panel of DiaMed-ID Micro Typing System (DiaMed AG, Cressier, Switzerland).
RESULTS
Positive results of antibody screening test were found in 52 cases (0.83%, 52/6,293). Only 28 cases of them were tested antibody identification. Antibody specificity was identified at 22 cases and 17 (77.3%, 17/22) women had unexpected antibodies which are not associated with HDN. They were 11 with anti-Lea , 3 with anti-Leb, and 3 with anti-P1. The others were 3 cases of anti-E, 1 of anti-M, and 1 of anti-S. However, no one had evidence of HDN.
CONCLUSION
These results suggest that routine prenatal antibody screening may not be necessary for all pregnant women except Rh (D) negative women or those who have a history of HDN.