Affiliation:
1. Department of Transfusion Medicine, Sanjay Gandhi Postgraduate Institute of Medical Sciences , Lucknow , India
Abstract
Abstract
Objective
In the setting of RhD-alloimmunized pregnancy, laboratory variations in critical titer (CT) of anti-D antibody may result in needless referrals or a compromised fetal outcome.
Methods
RhD-alloimmunized pregnant women were included. Fetal outcome was categorized based on cord hemoglobin and interventions required. For 3 commonly used CTs of 8, 16, and 32, sensitivity and specificity as well as positive and negative predictive values were computed.
Results
When compared with CTs of 16 and 32, we detected 6.9% and 19.4% more cases of moderate-severe hemolytic disease of the fetus and newborn by using 8 as the CT. However, this leads to greater rate of unnecessary referral (12.1%, 10/82) than a CT of 16 (8.2%, 6/73) and 32 (4.9%, 3/61). A CT of 8 demonstrated 100% sensitivity, but 12.1% (10/82) of patients were referred needlessly.
Conclusion
Because of its 100% sensitivity, we advocate decreasing the CT to 8. However, this may lead to unwarranted referrals.
Publisher
Oxford University Press (OUP)
Subject
Biochemistry (medical),Clinical Biochemistry
Cited by
2 articles.
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