A case for comprehensive antenatal screening for blood group antibodies.

OBJECTIVES To determine the frequency of various blood group antibodies responsible for haemolytic disease of the new born (HDN). DESIGN A prospective study of all neonates and still born foetuses suspected to have haemolytic disease of the new born and their mothers. SUBJECTS Neonates suspected to have HDN as per study criteria along with their mothers and mothers of still born foetuses with hydrops foetalis. METHODS Pertinent serological tests, serum bilirubin estimation, haemoglobin estimation and reticulocyte count on neonate's blood samples and demonstration/titration of blood group specific antibodies in maternal blood samples. RESULTS Six cases of HDN due to blood group antibodies were detected so far. Four were due to anti-D and all were of mild severity as per study criteria. Two cases were of severe haemolytic disease (hydrops foetalis). Both were due to anti Kell. Both women had history of previous blood transfusion and abortions. CONCLUSION Comprehensive antibody screening should be performed during antenatal period in women who have received blood transfusion and/or have history of un-explained abortions.