Abstract:
The current recommended testing algorithm for assessing the alloimmunized pregnancy utilized by many obstetricians in the United States (US) fails to consider the most recent evidence, placing fetuses, and mothers at unnecessary risk of poor outcome or death. This narrative review of the current landscape of fetal red blood cell (RBC) antigen testing evaluates the history of hemolytic disease of the fetus and newborn (HDFN) and how its discovery has continued to influence practices in the US today. We compare current US-based HDFN practice guidelines with those in Europe. We also provide transfusion medicine and hematology perspectives and recommendations addressing the limitations of US practice, particularly regarding paternal RBC antigen testing, and discuss the most valuable alternatives based on decades of data and evidence-based recommendations from Europe.
摘要:
目前推荐的用于评估美国许多产科医生使用的同种免疫妊娠的测试算法没有考虑最新的证据,放置胎儿,和母亲在不必要的风险不良结果或死亡。对胎儿红细胞(RBC)抗原测试当前形势的叙述性回顾评估了胎儿和新生儿溶血病(HDFN)的病史,以及其发现如何继续影响当今美国的实践。我们将当前美国的HDFN实践指南与欧洲的指南进行了比较。我们还提供输血医学和血液学观点和建议,以解决美国实践的局限性。特别是关于父系红细胞抗原检测,并根据欧洲数十年的数据和基于证据的建议讨论最有价值的替代方案。