ABO and Rh are the most important blood group systems with various distributions reported for different populations. Traditional ABO blood group and Rh serology is based on the immunoreactivity of antisera with the carbohydrate A, B and H antigens on Red Blood Cells (RBC). Due to its medical importance in relation to different diseases, pursuing a line of investigation on the ABO and Rh blood group systems has been of significance for years. It is well known that these blood group systems are of great importance in blood transfusion and organ transplantation. Furthermore, the susceptibility to several diseases has been associated with the ABO phenotype, but such correlation remains controversial. Progress in the molecular biology of the ABO system has recognized the molecular basis of the red blood cell antigens and has provided a genetic model for ABO polymorphism at the molecular level. The ABH antigens are not primary gene product, but they are the enzymatic reaction product of enzymes called glycosyltransferases. After the ABO system, the Rh (Rhesus) blood group system is regarded as the second most important blood group system, as some of the severe hemolytic transfusion reactions and most hemolytic disease of the fetus and new born (HDFN) cases are associated with antibodies to the Rh group antigens. Objectives: To determine ABO blood group and Rh factor phenotype antigens frequency, distribution, and document among paternity cases of Iraqi Medical Legal Directorate / Clinical Forensic Department / paternity and kinship division. Materials and Methods: The material and methods were used ABO and Rh kits for detection phenotype antigens of this blood types, the principle of test is one step immunological reaction. Total samples (1997) were referred to medical Legal Directorate (MLD). Out of the total participants there were 1815 (98.4%) of samples complete information for inclusion criteria. the sample were used for estimation of phenotypic distribution of ABO, Rh. ABO blood group serology was performed at MLD, Paternity and Kinship Division using commercially available monoclonal Anti-A, Anti-B, reagents according to the national blood bank standard operating procedures. The Method principle is based on antigen antibody reaction (agglutination) some tests were confirmed under microscope examination to see weak reaction. Results: The most common blood group was O (52.3%) and the least common was AB (3.18%).97.7% of the blood participants were Rh Positive and the rest were Rh Negative. Most participants were young adults, representing the age group of 19 – 29. Most participants were male (88.1%). Conclusion: Blood group O and Rh+ factor was dominant in both sexes, Up-to-date knowledge of the distribution of blood types in a local setting is critical to the functioning of any national health service. To date, there has been a lack of data in Iraqi population.
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