Clinical application of exempting anti-D monitoring in pregnant women with Asian-type DEL
10.13303/j.cjbt.issn.1004-549x.2025.06.003
- VernacularTitle:“亚洲型”DEL孕妇免去抗-D监测的临床应用
- Author:
Pin YI
1
;
Ziyu OU
2
;
Xiaoxiao SUN
3
;
Mingming WANG
1
;
Changlin WU
1
;
Chaopeng SHAO
1
Author Information
1. Shenzhen Second People's Hospital (The first affiliated hospital of Shenzhen university), Shenzhen 518035, China
2. Medical College of Shantou University, Shantou 518025, China
3. Shenzhen Nanshan People's Hosptial, Shenzhen 518052, China
- Publication Type:Journal Article
- Keywords:
Asian-type DEL;
anti-D;
RhD immunoglobulin;
allele
- From:
Chinese Journal of Blood Transfusion
2025;38(6):766-771
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the feasibility of exempting Asian-type DEL pregnant women from anti-D monitoring and RhD immunoglobulin prophylaxis injections by comparing and analyzing the clinical incidence of anti-D alloimmunization between Asian-type DEL pregnant women and true RhD-negative pregnant women. Methods: A total of 165 pregnant women who were initially screened as RhD negative by the saline method and received medical treatment in our hospital from December 2022 to August 2024 were collected as the research subjects. Absorption and elution tests, DEL genotyping, and gene sequencing were used to divide the pregnant women into the Asian-type DEL group and the true negative group. After obtaining informed consent, the following clinical management plan was implemented for pregnant women with Asian-type DEL: exemption from routine anti-D antibody detection, exemption from RhD immunoglobulin prophylaxis, and transfusion of RhD-positive red blood cells. Blood samples of newborns were sent for examination of hemolytic disease of the fetus and newborn (HDFN). The routine management plan was implemented for true negative pregnant women. The incidence of alloimmunization and HDFN was comparatively analyzed between the two groups. Results: Among 165 initially screened RhD negative pregnant women, serological testing and genotyping confirmed 42 as Asian-type DEL, 9 as D variant, and 114 as true negative. Among 42 pregnant women with Asian-type DEL, 3 cases tested positive for HDFN due to receiving RhD immunoglobulin prophylaxis injection. The remaining 39 cases were exempted from anti-D testing after being fully informed of the risk, and did not receive RhD immunoglobulin prophylaxis. The HDFN tests were all negative. In the true negative group, anti-D antibodies were detected in 20 cases, of which 6 cases tested positive for HDFN. A pregnant woman with Asian -type DEL did not show RhD homologous immune response after receiving 2 units of RhD positive red blood cells. Statistical analysis revealed a significantly lower risk of anti-D alloimmunization in Asian-type DEL carriers compared to true D-negative pregnant women (P<0.05). Conclusion: Pregnant women with Asian-type DEL can be exempted from routine anti-D antibody testing and do not require routine RhD immunoglobulin prophylaxis injections.
