Profile of Irregular Antibodies in Multiparous Pregnant Women and Its Implications for Maternal Transfusion Services at Gotong Royong Hospital, Surabaya

Authors

  • Wiwid Salsulhadi
  • Yustisia Amalia Kesehatan Program Studi D-III Teknologi Bank Darah, Fakultas Ilmu Kesehatan, Universitas Dr. Soetomo
  • Miftahul Khairoh Program Studi S-1 Kebidanan, Fakultas Ilmu Kesehatan, Universitas Dr. Soetomo

DOI:

https://doi.org/10.62354/jurnalmedicare.v5i3.588

Abstract

Background: Multiparous pregnancy increases maternal exposure to fetal red blood cell antigens that differ from maternal antigens, potentially triggering the formation of irregular antibodies. These antibodies have implications for maternal transfusion safety because they may complicate the selection of compatible blood and increase the risk of transfusion reactions and hemolytic disease in the fetus or newborn. Objective: This study aimed to identify the profile of irregular antibodies in multiparous pregnant women and analyze their implications for maternal blood transfusion services at Gotong Royong Hospital, Surabaya. Methods: This study employed a descriptive observational design with a cross-sectional approach. The subjects were multiparous pregnant women undergoing antenatal examinations. Laboratory examinations included ABO and Rhesus blood grouping, irregular antibody screening, and antibody identification in samples with positive screening results. Maternal characteristics, parity, transfusion history, and pregnancy history were analyzed descriptively. Results: Variations were found in the results of irregular antibody screening. The identified antibodies were evaluated based on their clinical significance for blood compatibility. Multiparity and a history of blood transfusion were important factors in pre-transfusion evaluation. Conclusion: Screening and identification of irregular antibodies are important to support the selection of compatible blood and improve the safety of maternal transfusion services.

Downloads

Download data is not yet available.

Keywords:

irregular antibodies, multiparity, pregnancy, antibody screening, maternal transfusion

Author Biographies

Wiwid Salsulhadi

Diploma III Blood Bank Technology Study Program, Faculty of Health Sciences, Universitas Dr. Soetomo, Surabaya, Indonesia.

Yustisia Amalia Kesehatan, Program Studi D-III Teknologi Bank Darah, Fakultas Ilmu Kesehatan, Universitas Dr. Soetomo

Diploma III Blood Bank Technology Study Program, Faculty of Health Sciences, Universitas Dr. Soetomo, Surabaya, Indonesia

References

1. American College of Obstetricians and Gynecologists. (2018). ACOG Practice Bulletin No. 192: Management of alloimmunization during pregnancy. Obstetrics & Gynecology, 131(3), e82–e90.

2. Ares, S. M., Nardozza, L. M. M., Araujo Júnior, E., & Santana, E. F. (2024). Non-RhD alloimmunization in pregnancy: An updated review. Revista Brasileira de Ginecologia e Obstetrícia, 46, e-rbgo22.

3. British Society for Haematology. (2025). Guideline for the investigation and management of red cell antibodies in pregnancy. Transfusion Medicine, 35(1), 3–23.

4. Das, S., Shastry, S., Rai, L., & Baliga, P. (2020). Frequency and clinical significance of red cell antibodies in pregnancy: A prospective study from India. Indian Journal of Pathology and Microbiology, 63(2), 241–246.

5. Dholakiya, S. K., Bharadva, S., Vachhani, J. H., & Upadhyay, B. S. (2021). Red cell alloimmunization among antenatal women attending tertiary care center in Jamnagar, Gujarat, India. Asian Journal of Transfusion Science, 15(1), 52–56.

6. Ding, J. J., Abels, E., Jacobs, J. W., Culhane, J., Lundsberg, L. S., Partridge, C., Denoble, A., & Kohari, K. (2024). Rate of clinically significant red blood cell antibody seroconversion in pregnancy. The Journal of Maternal-Fetal & Neonatal Medicine, 37, 2419370.

7. Gassner, C., Castilho, L., Chen, Q., et al. (2022). International Society of Blood Transfusion Working Party on Red Cell Immunogenetics and Blood Group Terminology report of Basel and three virtual business meetings: Update on blood group systems. Vox Sanguinis, 117(11), 1332–1344.

8. Gothwal, M., Singh, P., Bajpayee, A., Agrawal, N., Yadav, G., & Sharma, C. (2023). Red cell alloimmunization in pregnancy: A study from a premier tertiary care centre of Western India. Obstetrics & Gynecology Science, 66(2), 84–93.

9. Gupta, G. K., Balbuena-Merle, R., Hendrickson, J. E., et al. (2020). Immunohematologic aspects of alloimmunization and alloantibody detection: A focus on pregnancy and hemolytic disease of the fetus and newborn. Transfusion and Apheresis Science, 59(5), 102946.

10. Hassan, M. N., Mohd Noor, N. H., Johan Noor, S. R., Sukri, S. A., Mustafa, R., & Luc Aster, H. V. R. (2014). Hemolytic disease of fetus and newborn due to maternal red blood cell alloantibodies in the Malay population. Asian Journal of Transfusion Science, 8(2), 113–117.

11. Kahar, M. A. (2018). Frequency of red cell alloantibodies in pregnant females of Navsari District: An experience that favours inclusion of screening for irregular erythrocyte antibody in routine antenatal testing profile. Journal of Obstetrics and Gynaecology of India, 68(4), 300–305.

12. Karim, F., Moiz, B., & Kamran, N. (2015). Risk of maternal alloimmunization in Southern Pakistan: A study in a cohort of 1000 pregnant women. Transfusion and Apheresis Science, 52(1), 99–102.

13. Kementerian Kesehatan Republik Indonesia. (2016). Peraturan Menteri Kesehatan Republik Indonesia Nomor 91 Tahun 2015 tentang Standar Pelayanan Transfusi Darah. Kementerian Kesehatan RI.

14. Koelewijn, J. M., Vrijkotte, T. G. M., van der Schoot, C. E., Bonsel, G. J., & de Haas, M. (2008). Effect of screening for red cell antibodies, other than anti-D, to detect hemolytic disease of the fetus and newborn: A population study in the Netherlands. Transfusion, 48(5), 941–952.

15. Mandal, S., Malhotra, S., Negi, G., Tiwari, A., Mitra, S., & Basu, S. (2020). Severe hemolytic disease of the fetus and newborn due to anti-E and anti-Jkᵃ. Immunohematology, 36(2), 60–63.

16. Mayer, B., Hinkson, L., Hillebrand, W., Henrich, W., & Salama, A. (2018). Efficacy of antenatal intravenous immunoglobulin treatment in pregnancies at high risk due to alloimmunization to red blood cells. Transfusion Medicine and Hemotherapy, 45(6), 429–436.

17. Moinuddin, I., Fletcher, C., & Millward, P. (2019). Prevalence and specificity of clinically significant red cell alloantibodies in pregnant women: A study from a tertiary care hospital in Southeast Michigan. Journal of Blood Medicine, 10, 283–289.

18. Moise, K. J., Jr. (2000). Non-anti-D antibodies in red-cell alloimmunization. European Journal of Obstetrics & Gynecology and Reproductive Biology, 92(1), 75–81.

19. Moise, K. J., Jr., & Abels, E. A. (2024). Management of red cell alloimmunization in pregnancy. Obstetrics & Gynecology, 144(4), 465–480.

20. Moise, K. J., Jr., Markham, K. B., Spinella, P. C., et al. (2025). A clinical practice guideline for the management of pregnancy alloimmunized to red blood cell antigens. JAMA Network Open, 8(11), e2544649.

21. Nurul 'Adani, S., Mohd Ashari, N. S., Johan, M. F., Edinur, H. A., Mohd Noor, N. H., & Hassan, M. N. (2024). Red blood cell alloimmunization in pregnancy: A review of the pathophysiology, prevalence, and risk factors. Cureus, 16(5), e60158.

22. Ohto, H., Denomme, G. A., Ito, S., Ishida, A., Nollet, K. E., & Yasuda, H. (2020). Three non-classical mechanisms for anemic disease of the fetus and newborn, based on maternal anti-Kell, anti-Ge3, anti-M, and anti-Jrᵃ cases. Transfusion and Apheresis Science, 59(5), 102949.

23. Pahuja, S., Gupta, S. K., Pujani, M., & Jain, M. (2011). The prevalence of irregular erythrocyte antibodies among antenatal women in Delhi. Blood Transfusion, 9(4), 388–393.

24. Poole, J., & Daniels, G. (2007). Blood group antibodies and their significance in transfusion medicine. Transfusion Medicine Reviews, 21(1), 58–71.

25. Rodrigues, M. M. O., Mattos, D., Almeida, S., & Fiegenbaum, M. (2024). Hemolytic disease of the fetus and newborn: A perspective of immunohematology. Hematology, Transfusion and Cell Therapy, 46(Suppl. 2), S246–S257.

26. Royal College of Obstetricians and Gynaecologists. (2015). Blood transfusion in obstetrics: Green-top Guideline No. 47. Royal College of Obstetricians and Gynaecologists.

27. Sánchez-Durán, M. Á., Higueras, M. T., Halajdian-Madrid, C., Avilés García, M., Bernabeu-García, A., Maiz, N., Nogués, N., & Carreras, E. (2019). Management and outcome of pregnancies in women with red cell isoimmunization: A 15-year observational study from a tertiary care university hospital. BMC Pregnancy and Childbirth, 19(1), 356.

28. Slootweg, Y. M., Lindenburg, I. T., Koelewijn, J. M., van Kamp, I. L., Oepkes, D., & de Haas, M. (2018). Predicting anti-Kell-mediated hemolytic disease of the fetus and newborn: Diagnostic accuracy of laboratory management. American Journal of Obstetrics and Gynecology, 219(4), 393.e1–393.e8.

29. Sugrue, R. P., Moise, K. J., Jr., Federspiel, J. J., Abels, E., Louie, J. Z., Chen, Z., Bare, L., Alagia, D. P., & Kaufman, H. W. (2024). Maternal red blood cell alloimmunization prevalence in the United States. Blood Advances, 8(16), 4311–4319.

30. Webb, J., & Delaney, M. (2018). Red blood cell alloimmunization in the pregnant patient. Transfusion Medicine Reviews, 32(4), 213–219.

Downloads

Published

2026-07-31

How to Cite

Kesehatan, W. S., Kesehatan, Y. A., & Khairoh, M. (2026). Profile of Irregular Antibodies in Multiparous Pregnant Women and Its Implications for Maternal Transfusion Services at Gotong Royong Hospital, Surabaya. Jurnal Medicare, 5(3), 1086–1099. https://doi.org/10.62354/jurnalmedicare.v5i3.588

Similar Articles

1 2 3 4 5 6 7 8 > >> 

You may also start an advanced similarity search for this article.