Significance of Irregular Red Blood Cell IgG of Pregnant Women in Early Diagnosis of Non-ABO-HDN

Objective To explore the significance of irregular red blood cell(RBC)IgG of pregnant women in the early diagnosis of non-ABO-HDN.Methods Screen irregular RBC antibody in 4 200 pregnant women.The women positive for irregular RBC antibody were tested for specificity of antibody as well as type and titer of Ig.The umbilical cord blood or the blood of newborns from pregnant women positive for irregular RBC IgG were collected after parturition for diagnosis of HDN by test for free antibody in sera as well as direct RBC antiglobulin test and RBC antibody release test.Results Of the 4 200 pregnant women,44(1.05%)were positive for irregular RBC antibody,of which 20 were positive for IgG or IgG and IgM mixed antibody.The fetus of one pregnant woman positive for irregular RBC IgG died in uterus at the 20th weeks after pregnancy,and of the 19 newborns delivered by the other 19 pregnant women,10 were diagnosed as non-ABO-HDN.The distribution of specificity of pathogenic antibody in the dead fetus and the newborns with non-ABO-HDN was as follows:2 cases of anti-D,1 case of anti-c,2 cases of anti-E,1 case of anti-cE and 4 cases of anti-M(including 1 case complicated with anti-A).Conclusion The IgG and anti-IgM of Rh blood group system in pregnant women may cause HDN in newborn.The detection of irregular RBC antibody is of important significance in early diagnosis of non-ABO-HDN,differentiation of antibody type causing HDN,evaluation of severity of HDN and selection of therapeutic protocol.