Læknablaðið - 01.07.2016, Blaðsíða 15

LÆKNAblaðið 2016/102 331
R A N N S Ó K N
ENGLISH SUMMARY
Introduction: Hemolytic disease of the fetus and newborn (HDFN)
is caused by the destruction of fetal red blood cells due to red cell
antibodies produced by the mother. HDFN can cause fetal hydrops
during pregnancy or neonatal jaundice after birth. Direct Antiglobulin
Test (DAT) detects antibodies bound to red cells and is a valuable test
aiding in the diagnosis of HDFN. In Iceland DAT is routinely performed on
cord blood or newborn blood samples if the mother is Rhesus D negati-
ve or has non-A/B red cell alloantibodies. The aim of this study was to
investigate the causes and consequences of positive DAT in newborns in
Iceland over a period of eight years.
Material and methods: The study population was infants diagnosed
with a positive DAT in the Blood Bank in Iceland in the years 2005-2012.
Relevant data on the blood group and antibody status of mother and
child, blood transfusion and DAT results were retrieved from the Blood
Bank information system ProSang. Birth records provided information on
birth weight, gestational age and phototherapy. Health records from the
Children's Hospital provided information on the management and fate of
the newborn.
Results: Over the study period 383 newborns had a positive DAT result
at the Blood Bank. In 73.6% of cases the underlying cause was ABO
blood group mismatch between mother and infant, in 20.4% of cases
the mother had non-A/B red cell alloantibodies, in 3.9% both of above
factors were present, while in 2.1% the cause was unclear. A total of 179
(47.6%) children had neonatal jaundice that required treatment, of which
167 (93.3%) only needed phototherapy. Eight infants required exchange
transfusion, five of these had Rhesus antibodies and three ABO blood
group mismatch.
Conclusion: ABO blood group mismatch between mother and child
was the most common cause for a positive DAT in neonates in Iceland
in the years 2005-2012. Almost half of the neonates required treatment
but usually phototherapy was sufficient. Rarely, blood transfusion or
exchange transfusion was necessary in severe cases of ABO blood
group mismatch or non-A/B red cell alloantibodies.
Positive Coomb’s test in newborns; causes and clinical consequences
Summary of cases diagnosed in the Blood Bank in the years 2005 to 2012
Thordis Kristinsdottir1, Sveinn Kjartansson2, Hildur Hardardottir1,3, Thorbjörn Jonsson4, Anna Margret Halldorsdottir4
1Faculty of Medicine, University of Iceland, 2Children's Hospital of Landspítali, 3Department of Obstetrics and Gynecology, Landspítali, 4The Blood Bank, Landspítali.
Key words: Coombs test, Direct Antiglobulin Test (DAT), Hemolytic disease of the fetus and newborn (HDFN), ABO blood group mismatch, red cell alloantibodies, neonatal jaundice,
exchange transfusion.
Correspondence: Anna Margrét Halldórsdóttir, annamha@landspitali.is
Heimildir
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