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Quraishy N, Sapatnekar S. Immunohematological testing and transfusion management of the prenatal patient. Adv Clin Chem 2023; 117:163-208. [PMID: 37973319 DOI: 10.1016/bs.acc.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
The primary indication for immunohematological testing in the prenatal patient is to detect and identify maternal red cell antibodies. If there are antibodies that are expected to hemolyze the fetus' red cells, their strength of reactivity must be tested, and the fetus' antigen status determined. After delivery, testing is performed to assess the extent of fetomaternal hemorrhage, as a large hemorrhage may require other therapeutic interventions. Another major role for immunohematological testing is to select blood components appropriately when intrauterine transfusion is required for fetal anemia resulting from maternal alloimmunization or some other cause. Supplementation with molecular methods has transformed the practice of immunohematology, particularly as it applies to typing for the D antigen of the Rh blood group system. Notwithstanding the advances in testing, close coordination and communication between the transfusion service and the obstetrics service are the foundation for ensuring the finest care for prenatal patients, and for new mothers and their infants. This review describes testing and transfusion practices for prenatal patients, using case presentations to highlight the management of selected immunohematological findings. It also includes a discussion of key patient management topics that are currently unresolved.
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Affiliation(s)
- NurJehan Quraishy
- Section of Transfusion Medicine, Department of Laboratory Medicine, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Suneeti Sapatnekar
- Section of Transfusion Medicine, Department of Laboratory Medicine, Robert J. Tomsich Pathology & Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, United States.
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Clarke G, Bodnar M, Lozano M, Nadarajan VS, Lee C, Baud D, Canellini G, Gleich-Nagel T, Torres OW, Rey PL, Bonet Bub C, Mauro Kutner J, Castilho L, Saifee NH, Delaney M, Nester T, Wikman A, Tiblad E, Pierelli L, Matteocci A, Maresca M, Maisonneuve E, Cortey A, Jouannic JM, Fornells J, Albersen A, De Haas M, Oepkes D, Lieberman L. Vox Sanguinis International Forum on the selection and preparation of blood components for intrauterine transfusion: Summary. Vox Sang 2020; 115:813-826. [PMID: 32400093 DOI: 10.1111/vox.12901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Gwen Clarke
- Canadian Blood Services, University of Alberta, 8249 114 St. NW, Edmonton, AB, T6G 2R8, Canada
| | - Melanie Bodnar
- Laboratory Medicine and Pathology Royal Alexandra Hospital, 10240 Kingsway Avenue, Edmonton, AB, T5H 3V9, Canada
| | - Miquel Lozano
- Department of Hemotherapy and Hemostasis, Hospital Clinic, Villaroel 170, Barcelona, 08036, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Lani Lieberman
- Department of Laboratory Hematology (Transfusion Medicine), University Health Network and Affiliated Hospitals, University of Toronto, 306 - 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada
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Clarke G, Bodnar M, Lozano M, Nadarajan VS, Lee C, Baud D, Canellini G, Gleich-Nagel T, Torres OW, Rey PL, Bub CB, Kutner JM, Castilho L, Saifee NH, Delaney M, Nester T, Wikman A, Tiblad E, Pierelli L, Matteocci A, Maresca M, Maisonneuve E, Cortey A, Jouannic JM, Fornells J, Albersen A, de Haas M, Oepkes D, Lieberman L. Vox Sanguinis International forum on the selection and preparation of blood components for intrauterine transfusion. Vox Sang 2020; 115:e18-e38. [PMID: 32400066 DOI: 10.1111/vox.12902] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | | | - Veera Sekaran Nadarajan
- University Malaya Medical Centre, Jalan Universiti, Lembah Pantai 50603, Kuala Lumpur, Malaysia
| | - Christina Lee
- University Malaya Medical Centre, Jalan Universiti, Lembah Pantai 50603, Kuala Lumpur, Malaysia
| | - David Baud
- Materno-fetal and Obstetrics Research Unit, Department "Femme-Mère-enfant", University Hospital, Rue du Bugnon 21 1011, Lausanne, Switzerland
| | - Giorgia Canellini
- Interregional Blood Transfusion SRC, Rue du Bugnon 46 1011, Lausanne, Switzerland
| | - Tobias Gleich-Nagel
- Interregional Blood Transfusion SRC, Rue du Bugnon 46 1011, Lausanne, Switzerland
| | - Oscar Walter Torres
- Transfusion Medicine Unit, Hospital Materno-Infantil Ramón Sarda, Esteban de Luca 2151, City of Buenos Aires, Argentina
| | - Patricia L Rey
- Obstetric Immunohematology Section, Hospital Materno-Infantil Ramón Sarda, Esteban de Luca 2151, City of Buenos Aires, Argentina
| | - Carolina Bonet Bub
- Hemotherapy and Cell Therapy Department, Albert Einstein Hospital, Avenida Albert Einstein, 627- 30 andar Bloco E, São Paulo, Brazil
| | - José Mauro Kutner
- Hemotherapy and Cell Therapy Department, Albert Einstein Hospital, Avenida Albert Einstein, 627- 30 andar Bloco E, São Paulo, Brazil
| | - Lilian Castilho
- Hemotherapy and Cell Therapy Department, Albert Einstein Hospital, Avenida Albert Einstein, 627- 30 andar Bloco E, São Paulo, Brazil.,Blood Bank, State University of Campinas, Carlos Chagas Street,480, 13083-878, São Paulo, Brazil
| | - Nabiha H Saifee
- Seattle Children's and Bloodworks Northwest, 4800 Sand Point Way NE, M/S OC.8.720, Seattle, WA, USA
| | - Meghan Delaney
- Children's National Hospital, 111 Michigan Ave NW, Washington, DC, USA
| | - Theresa Nester
- Bloodworks Northwest, 921 Terry Avenue, Seattle, WA, 98104, USA
| | - Agneta Wikman
- Clinical Immunology and Transfusion Medicine, Karolinska University Hospital, 14186, Stockholm, Sweden
| | - Eleonor Tiblad
- Center for Fetal Medicine, Karolinska University Hospital, 14186, Stockholm, Sweden
| | - Luca Pierelli
- Transfusion Medicine, San Camillo Forlanini Hospital, 00152, Rome, Italy.,Department of Experimental Medicine, Sapienza University, 00161, Rome, Italy
| | | | - Maddalena Maresca
- Servizio di Emotrasfusione, Istituto di Ematologia-Fondazione Policlinico Universitario, "A. Gemelli"-IRCCS, 00168, Rome, Italy
| | - Emeline Maisonneuve
- Fetal Medicine Department, CNRHP Clinical Unit, Hôpital Trousseau, 26 rue Arnold Netter, 75012, Paris, France
| | - Anne Cortey
- CNRHP Clinical Unit, Hôpital Trousseau, 26 rue Arnold Netter, 75012, Paris, France
| | - Jean-Marie Jouannic
- Fetal Medicine Department, CNRHP Clinical Unit, Hôpital Trousseau, 26 rue Arnold Netter, 75012, Paris, France
| | - Jordi Fornells
- University Clinic Hospital, Biomedical Diagnostic Center, University Clinic Hospital, Sabino Arana 1, 08028, Barcelona, Spain
| | - Arjan Albersen
- Specialist in Laboratory Medicine (EuSpLM), Leiden University Medical CenterDepartment of Clinical Chemistry and Laboratory Medicine, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
| | - Masja de Haas
- Sanquin Diagnostic Services and Center for Clinical Transfusion Research, Plesmanlaan 125, 1066 CX, Amsterdam, The Netherlands
| | - Dick Oepkes
- Leiden University Medical Center, Dept of Obstetrics and Fetal Medicine, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands
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Schonewille H, Prinsen-Zander KJ, Reijnart M, van de Watering L, Zwaginga JJ, Meerman RH, van Kamp IL, Brand A. Extended matched intrauterine transfusions reduce maternal Duffy, Kidd, and S antibody formation. Transfusion 2015; 55:2912-9; quiz 2911. [DOI: 10.1111/trf.13231] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 04/24/2015] [Accepted: 06/08/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Henk Schonewille
- Center for Clinical Transfusion Research; Sanquin Research
- Jon J. van Rood Center for Clinical Transfusion Research; Sanquin-Leiden University Medical Center
| | - Karin J.M. Prinsen-Zander
- Department of Immuno-hematology and Blood Transfusion; Leiden University Medical Center; Leiden the Netherlands
| | - Mila Reijnart
- Sanquin Blood Bank, Sanquin Blood Supply; Dordrecht the Netherlands
| | - Leo van de Watering
- Center for Clinical Transfusion Research; Sanquin Research
- Jon J. van Rood Center for Clinical Transfusion Research; Sanquin-Leiden University Medical Center
| | - Jaap-Jan Zwaginga
- Center for Clinical Transfusion Research; Sanquin Research
- Department of Immuno-hematology and Blood Transfusion; Leiden University Medical Center; Leiden the Netherlands
| | - Robertjan H. Meerman
- Department of Obstetrics and Fetal Medicine; Leiden University Medical Center; Leiden the Netherlands
| | - Inge L. van Kamp
- Department of Obstetrics and Fetal Medicine; Leiden University Medical Center; Leiden the Netherlands
| | - Anneke Brand
- Jon J. van Rood Center for Clinical Transfusion Research; Sanquin-Leiden University Medical Center
- Department of Immuno-hematology and Blood Transfusion; Leiden University Medical Center; Leiden the Netherlands
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