The management of women with red cell antibodies during pregnancy is one of those ones I think it is worth us knowing a bit about, as it does come up, but mostly these women will be managed by obs.
In about 1.2% of pregnancies, women will have red cell antibodies. In about 0.4% of pregnancies this will cause a clinically significant problem. They are generally checked at booking and at 28 weeks and occasionally we are the ones looking at the result and making a decision about what to do.
What is the significance of this?
The presence of red cell antibodies means that allo-immunisation has occurred. This can be due to a previous pregnancy, transfusion or transplant. These antibodies can cause Haemolytic Disease of the Fetus and Newborn (HDFN). Maternal IgG antibodies to the baby’s antigens cross the placenta. This can cause haemolysis in the baby, both in utero and neonatally, which can lead to a need for intrauterine or neonatal transfusion, jaundice or perinatal loss.