Abstract

Blood group iso-immunization has occurred when the fetal plasma contains maternal antibodies to fetal red cell antigens. The iso-haemagglutinins (the normal blood group antibodies) are predominantly IgM and do not cross the placental barrier (see chapter 1), but immune antibodies, formed in the mother as a result of contact with antigens not present in her, are IgG and therefore transported through the placenta. Contact with a ‘foreign’ blood group antigen may occur by transplacental transfusion during pregnancy or treatment with unsuitable donor blood. A few vaccines, e.g. some diphtheria toxoids and influenza vaccines, contain traces of material from hog stomach or chick embryo which have been shown to stimulate the formation of immune antibodies in the recipient. Immune (IgG) antibodies crossing the placenta react with their antigens on the surface of the red cell. This reaction alters the surface structure of the red cell in such a way that they are removed from the circulation by the reticulo-endothelial system and broken down.

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