Patient's question:
Type O positive RH(D) husband, blood type B, 18 weeks pregnant, blood test IgG anti-B antibody titer 32, antibody screening negative, is there a problem?? What kind of assistance is needed: There is a possibility of getting neonatal hemolytic disease???...Doctor's answer:
Hemolytic disease is a self-limiting immune-related syndrome associated with hemolysis that occurs in fetuses and early neonates, primarily seen in the ABO blood group system [1, 2, 3]. The titer of IgG antibodies in a pregnant woman's serum is of significant importance in predicting the occurrence of HDN and serves as an expanded basis for early diagnostic confirmation.Guidance: Reports indicate that the level of IgG antibodies in a pregnant woman's serum is directly related to the incidence of neonatal hemolytic disease [5]. Currently, in clinical diagnosis, 64 is often used as a critical value. If the mother's serum titer of IgG anti-A (anti-B) is ≥64, it suggests the infant has a risk of harm and requires close monitoring. If the mother's serum titer of IgG anti-A (anti-B) is ≥128, it indicates a high likelihood of harm to the infant. Clinical diagnosis should pay attention to pre-pregnancy blood type incompatibility between the couple, especially in pregnant women with blood type O.
Therefore, for couples with ABO blood type incompatibility in early pregnancy (around 20 weeks), it is recommended to conduct antibody tests at 16 weeks, 28 weeks, and 36 weeks of gestation. For pregnant women with a titer of IgG anti-A (anti-B) ≥128, necessary treatment measures should be taken to reduce the IgG serum antibodies in the mother's body. These measures may include oral administration of Chinese herbal medicine Chenpi decoction, intravenous administration of vitamin C and 50% glucose, intravenous injection of immunoglobulin, plasma exchange, or intrauterine surgery if necessary, to suppress and reduce the titer of IgG anti-A (anti-B) in the mother's body and mitigate hemolysis in the fetus.