The prevalence and clinical significance of irregular antibodies other than ABO in Rh negative pregnant women in tertiary care hospital

ABSTRACT

Introduction: Routine pre transfusion testing consists of ABO and Rh typing, antibody screening and compatibility testing. The purpose of the antibody screen is to detect red blood cell antibodies other than Anti-A or Anti-B. These antibodies are called ‘unexpected’ because only 0.3 to 2% of the general population have positive antibody screen. Objective: This study was undertaken to know the prevalence of irregular antibodies in Rh negative pregnant women and also to analyse the clinical significance of these antibodies in the form of neonatal outcome. Materials and method: A Prospective study was conducted on the study population from September 2011 to Feuary 2013. During this period all the antenatal cases reporting in the department of Obstetrics and Gynaecology, Safdarjung hospital, New Delhi were typed for ABO and D antigen. Out of these antenatal cases 500 Rh negative pregnant women were included in the study and were screened for red blood cell alloantibodies by performing Indirect Coomb’s test(ICT). The specificity of the antibody was identified by further testing of those samples that gave positive reaction on initial screening.All these Rh negative antenatal cases were followed up and their neonates were examined for the evidence of hemolysis in the form of anaemia, jaundice, splenomegaly. Results: This study noted the prevalence of irregular red cell antibodies in 4.2% of pregnant women. Anti-D is the most common Antibody identified. accounting for 66.7%. Anti-C and anti-D together accounted for 23.9%. Anti-Kell and Anti-Jkb were identified in 0.4%. Incidence of neonatal anemia is significantly higher in babies born to mothers with RBC antibodies. Conclusion: The prevalence of irregular Red Cell Antibodies in Rh negative women is 4.2%.