The conventional test tube (CTT) remains the most frequently used method in India to detect hemolytic disease of the fetus and newborn (HDFN)-causing anti D antibodies, according to a recently published study in Transfusion Medicine.
An incompatibility of red blood cell (RBC) antigens between the mother and fetus can lead to the production of antibodies targeting the incompatible antigen in the fetus’s RBCs when the mother is exposed to fetal blood during birth. These antibodies can then cause HDFN in a subsequent pregnancy.
Anti-D antibodies are the most commonly associated with developing HDFN; therefore, accurate diagnostic tests that enable their detection are a crucial part of prenatal care. The detection of anti-D antibodies in maternal blood permits physicians to intervene appropriately and promptly to prevent fetal death.
Learn more about HDFN testing and diagnosis
The authors aimed to assess the most commonly used methods for anti-D screening in India. To do this, they sent a survey to over 40 tertiary centers nationwide.
Results showed that 27 centers, representing approximately 57% of the sample, used the CTT technique. The column agglutination technique (CAT) was the second most popular technique used in the remaining centers. Only 26% of centers reported using two or more methods simultaneously.
Regarding testing practices, over 90% of the centers performed anti-D testing in all RhD-negative mothers, and over 50% of centers performed it in all pregnant patients at the moment of registration, independent of RhD status.
The authors attributed the findings to the lower costs associated with CTT compared to CAT, and argued that the increased likeness of CAT to produce false positives may also have played a role.
“This survey provides us with an insight related to some major aspects of the processes involved in anti-D titration and also shows us that most of the major centers prefer existing established methods over newer modalities,” the authors concluded.
