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Mononuclear phagocyte assays, AutoAnalyzer quantitation and IgG subclasses of maternal anti‐RhD in the prediction of the severity of haemolytic disease in the fetus before 32 weeks gestation
Author(s) -
Garner S. F.,
Wiener E.,
Contreras M.,
Nicolini U.,
Kochknour N.,
Letsky E.,
Rodeck C. H.
Publication year - 1992
Publication title -
british journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.907
H-Index - 186
eISSN - 1365-2141
pISSN - 0007-1048
DOI - 10.1111/j.1365-2141.1992.tb06406.x
Subject(s) - fetus , immunology , antibody , subclass , serology , gestation , antibody dependent cell mediated cytotoxicity , medicine , andrology , placenta , pregnancy , biology , monoclonal antibody , genetics
Summary. In 40 cases of haemolytic disease of the fetus due to RhD immunization where the fetus required intrauterine transfusion, fetal packed cell volume was compared with the following parameters of maternal anti‐D: (a) concentration, (b) IgG subclass, (c) activity in a macrophage binding assay, and (d) activity in a monocyte antibody‐dependent cell mediated cytotoxicity (ADCC) assay. The anti‐D concentration exceeded 4 iu/ml in all cases, correctly indicating the risk of haemolytic disease. A relationship between IgG subclass composition of the anti‐D and severity of anaemia was not observed; IgGl, IgG3 and IgG 1 + 3 antibodies were all detected. The AüCC assay gave the best correlation between assay results and fetal packed cell volume: high results correctly indicated fetal anaemia in 95% of cases. Macrophage binding assay results were only considered as high in 70% of cases. Overall, these results indicate that serological tests and bioassays in highly immunized mothers may not generate any information that proves more useful than ultrasonography and their previous obstetric history.