RBC abs and critical titers according to Swedish national guidelines 2015
Risk for HDFN . | Types of RBC abs . |
---|---|
High risk | Anti-D |
Anti-K | |
Anti-c | |
Moderate risk | Anti-C |
Anti-e | |
Anti-E | |
Anti-k | |
Anti-Fya | |
Anti-U | |
Low risk | Anti-Cw |
Anti-f | |
Anti-Jka | |
Anti-Jkb | |
Anti-M | |
Anti-Kpa | |
Anti-Kpb | |
Anti-Yta | |
Anti-Coa | |
Anti-Cob | |
Anti-Ge2,3 | |
Titer | Management implication |
1-8 | Not critical for the fetus, but an indication for continued surveillance with antibody titers. The exception is anti-K where monitoring with Doppler interrogation of MCA PSV should start at titer ≥8. |
16-32 | Low risk of severe HDFN, but neonatal hyperbilirubinemia requiring phototherapy is possible. |
≥64 | Close monitoring, including Doppler interrogation of MCA PSV. Risk of need for neonatal exchange transfusion. |
≥128 | Close monitoring, including Doppler interrogation of MCA PSV. Intrauterine blood transfusion/neonatal exchange transfusion may be required. |
Risk for HDFN . | Types of RBC abs . |
---|---|
High risk | Anti-D |
Anti-K | |
Anti-c | |
Moderate risk | Anti-C |
Anti-e | |
Anti-E | |
Anti-k | |
Anti-Fya | |
Anti-U | |
Low risk | Anti-Cw |
Anti-f | |
Anti-Jka | |
Anti-Jkb | |
Anti-M | |
Anti-Kpa | |
Anti-Kpb | |
Anti-Yta | |
Anti-Coa | |
Anti-Cob | |
Anti-Ge2,3 | |
Titer | Management implication |
1-8 | Not critical for the fetus, but an indication for continued surveillance with antibody titers. The exception is anti-K where monitoring with Doppler interrogation of MCA PSV should start at titer ≥8. |
16-32 | Low risk of severe HDFN, but neonatal hyperbilirubinemia requiring phototherapy is possible. |
≥64 | Close monitoring, including Doppler interrogation of MCA PSV. Risk of need for neonatal exchange transfusion. |
≥128 | Close monitoring, including Doppler interrogation of MCA PSV. Intrauterine blood transfusion/neonatal exchange transfusion may be required. |
Reproduced from Liu et al,24 with permission.
MCA, middle cerebral artery; PSV, peak systolic velocity.