anti-D Titer Research Articles

Foetomaternal transfusion as a cause of neonatal anaemia.

After Levine, Burnham, Katzin and Vogel (1941) had described iso-immunization to the Rh factor, they postulated that sensitization might occur by passage of foetal red cells into the maternal circulation. Wiener (1948) first reported such a clinical example. Later Chown (1954) presented convincing evidence that foetomaternal transfusion was a definite entity. Chown (1955) utilized three methods in his case for demonstrating passage of foetal cells into the maternal circulation. First he observed an elevated level of foetal type haemoglobin in the mother's blood. Second, by differential serum agglutination, he showed that red cells with foetal type antigen were present in the maternal circulation. Third, he observed a progressive rise in anti-D indirect Coombs titre in the mother. Since Chown's proof of foetomaternal transfer, Colebatch, Pitt and Maddison (1956), Borum, Loyd and Talbot (1957), Gunson (1957), Shiller (1957), Goodall, Graham, Miller and Cameron (1958), McGovern, Driscoll, DuToit, Grove-Rasmussen and Bedell (1958), and Pearson and Diamond (1959) have reported further examples. Chown's case report is the only one thus far in which all three methods enumerated above were used to prove that foetomaternal transmission had taken place. The case reported here includes proof of such foetomaternal red cell transfer by determination of elevated levels of foetal haemoglobin, by a rising anti-D titre and by detection of infant's cells in the mother's circulation using differential agglutination. The observations are submitted to confirm those of Chown. Case History Infant Q. was born on November 28, 1958. No signs of foetal or maternal distress had been noted. At delivery, however, the infant was pale and listless.

Rh antibody stimulation with an Rh-negative fetus (Rh anamnestic reaction) and its significance to the newborn

1. The Rh anamnestic reaction was studied in three rh-negative mothers. Each had become previously sensitized to the D factor. High anti-D titers developed in dd mothers although this time carrying dd fetuses.2. Because the course of antibody levels resembles that of incompatible pregnancies, it is concluded that it is not possible to distinguish, by means of the antibody behavior alone, between a benign anamnestic reaction and one which may lead to erythroblastosis.3. In each of the three cases studied, pregnancy had been electively terminated because of concern for the fetus. The three babies were without signs of erythroblastosis fetalis, although one infant died from respiratory complications incidental to the intervention.4. It is concluded that obstetric or pediatric intervention based on maternal Rh antibody production alone is not well advised. Intervention may serve only to expose mother or child or both to such risks as are inherent in the interventions themselves.