Improved data sharing across blood banks could prevent delays and protect infants from hemolytic disease of the fetus and newborn (HDFN), as demonstrated by a recent case involving a 25-year-old pregnant woman whose rare antibody was missed due to gaps in electronic medical record systems, according to a case study published recently in Transfusion.
This case highlights how better access to transfusion history through national databases can improve maternal and fetal outcomes. At 16 weeks’ gestation, the patient, with blood group O and Rh(D+), underwent routine prenatal testing. Her antibody screen showed reactivity with all test cells, but the cause was unclear.
The findings suggested an antibody to a high-frequency antigen, prompting an extensive workup. She had no documented transfusion history in her hospital’s electronic medical record or in affiliated systems, delaying identification of the antibody and consuming 16 hours of staff time across three days.
Further investigation revealed a crucial detail outside the hospital’s network: the patient previously received care at another facility, where she was documented to have anti-Lub antibodies. The Lub antigen, present in more than 99% of people, is located on the Lutheran glycoprotein.
Read more about testing and diagnosis for HDFN
Allo anti-Lub, usually of the IgG type, can cross the placenta and cause mild HDFN by attacking fetal red blood cells. The patient’s antibody titer of 1:8 and the father’s homozygous Lub status suggested potential fetal risk. The medical team began following maternal-fetal medicine protocols to monitor for HDFN.
Although the patient did not require a transfusion, delays in identifying her antibody increased testing costs and could have endangered future transfusions or pregnancies. The case underscores how fragmented transfusion record systems can hinder timely care.
To prevent recurrence, the hospital shared the patient’s blood bank data with the Alloantibody Exchange, a nonprofit database that securely connects transfusion records from more than 1 million patients nationwide.
“The AE’s [Alloantibody Exchange] success currently depends on institution-by-institution data interface,” stated the authors of this case study.
Automated data sharing between the AE and hospital systems allows clinicians to identify known antibodies more quickly.
Experts believe wider participation in the Alloantibody Exchange could enhance transfusion safety, streamline blood compatibility testing, and reduce healthcare costs. For patients, especially pregnant women and those with rare antibodies, national record integration may mean the difference between a delayed diagnosis and a safe, healthy outcome for both mother and child.
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