Premium
The ability of the chemiluminescence test to predict clinical outcome and the necessity for amniocenteses in pregnancies at risk of haemolytic disease of the newborn
Author(s) -
Hadley Andrew G.,
Wilkes Anthony,
Goodrick Jean,
Penman David,
Soothill Peter,
Lucas Geoffrey
Publication year - 1998
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/j.1471-0528.1998.tb10059.x
Subject(s) - chemiluminescence , haemolysis , autoanalyzer , medicine , bilirubin , haemolytic disease , fetus , obstetrics , pregnancy , gastroenterology , immunology , chemistry , chromatography , biology , genetics
The chemiluminescence test measures the ability of anti‐D to sensitise red cells for recognition by monocytes. It predicts clinical outcome in haemolytic disease of the newborn with greater precision than quantification of anti‐D levels by Auto Analyzer. However, whether or not the chemiluminescence test can, or should, affect clinical management is not clear. Of 56 alloimmunised women referred to a single fetal medicine unit, 30 underwent a total 63 amniocenteses to establish the extent of fetal haemolysis. Overall, chemiluminescence test results were a better predictor of amniocenteses with elevated bilirubin levels than the AutoAnalyzer ( P < 0.01 ). Chemiluminescence results > 30% were always associated with elevated bilirubin levels. The chemiluminescence test might be used to prompt the direct evaluation of fetal haemolysis in patients with borderline levels of anti‐D (5–15 IU/mL). However, the ability of the test to predict amniocenteses with normal bilirubin levels was less clear.