Assessing Recommendations for Determining Fetal Risk in Alloimmunized Pregnancies in the United States: Is It Time to Update a Decades-Old Practice?

Document Type

Article

Publication Title

Transfusion medicine reviews

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.

First Page

150810

DOI

10.1016/j.tmrv.2023.150810

Publication Date

4-1-2024

Identifier

38194730 (pubmed); 10.1016/j.tmrv.2023.150810 (doi); S0887-7963(23)00100-1 (pii)

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