SIGNIFICANCE OF ALLOANTIBODY STUDIES IN WOMEN DURING PREGNANCY

Objective. To analyze the frequency of alloantibodies and to show their clinical significance for Rh-positive pregnant women. Subjects and methods. The frequency of anti-erythrocyte alloantibodies was studied in 2415 pregnant women. The gel agglutination assay was used to determine antibodies to erythrocyte antigens. Results. Antibodies to erythrocyte antigens were detected in 75 women. The detection rate of alloimmunized women was 3.1%. Among the sensitized women, there was a preponderance of Rh-negative women (78.7%). The Rh-negative women were found to have alloantibodies to antigens only in the Rhesus system. The common cause of allosensitization was anti-D. The Rh-positive women were detected to have alloantibodies to both antigens in the Rhesus system (anti-E, anti-сE, anti-c, anti-C, and anti-Cw) and to those in other ones (KELL, Lewis, and Lutheran). One woman with complicated pregnancy subsequently developed a severe posttransfusion hemolytic complication caused by anti-c antibodies. Antibodies to a k antigen in the KELL system were identified in another woman in our study. In this clinical case, anti-k antibodies unidentified during pregnancy made it impossible to transfuse blood components. Conclusion. The example of clinical cases shows the importance of screening anti-erythrocyte alloantibodies in Rh-positive pregnant women, which should be included in normative documents and introduced into routine practice.

antigens, anti-erythrocyte alloantibodies, pregnancy, allosensitization, posttransfusion complication