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Indirect comb test shows positive in undiluted serum. Its effect on pregnancy? How to cure?

Hi, My wife s blood group is A negative and my blood group is A positive and now she is 16 week pregnant. This is her first pregnancy and there were no miscarriages . We have done test for Indirect coombs Test and it says positive in undiluted serum . Could you please let me know what are the effects of that and a cure for it?
Asked On : Tue, 1 Jan 2013
Answers:  2 Views:  185
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Pathologist and Microbiologist 's  Response
hi there, indirect coomb's positive suggests that there are incomplete antibodies which the mother produces (including IgG) against the Rhesus D antigen on her baby's red blood cells.More than the test being positive, the titre are indicative of the level of complication that can be expected during and post child birth. Her tirers need to be monitered through out her pregnancy. Usually this condition is not detrimental to the first pregnancy but still it needs to be monitered routinely with Serial Ultrasound and Doppler examinations and quantitative analysis of maternal anti-RhD antibodies or titers of indirect coom's test.It is very rare for the first Rh positive baby of a Rh negative woman to be affected by Rh disease.Most Rh disease can be prevented by treating the mother during pregnancy or promptly (within 72 hours) after childbirth.All Rh D negative pregnant women are given an anti-RhD IgG immunoglobulin injection at about 28 week gestation (with or without a booster at 34 weeks gestation) or promptly (within 72 hours) after childbirth. This prevents the complications of Rh-ve pregnancy to present itself in the subsequent pregnancies. Hope this answers your queries. Take care.
Answered: Wed, 2 Jan 2013
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OBGYN Dr. Aarti Abraham's  Response
Mar 2013
Thanks for your query.
A positive Indirect coombs test, means that your wife , who is A negative, has developed antibodies already to the baby's blood, which is A positive.
Also, it is very rare for this to happen in the first pregnancy itself, unless there were prior miscarriages, or some bleeding or intervention in this current pregnancy.
When these antibodies are present in the mother's blood, they have a chance of crossing the placenta ,and reaching the baby, and then causing destruction of the Positive group blood cells which baby has.
Thus, the baby is at risk of anemia, jaundice, swelling etc and other complications because of that.
Right now, you can take the following steps
Be in regular follow up with your obstetrician
Keep getting the Indirect Coombs test done at regular intervals as advised.
At the critical titre ( critical level ), she might ask you to go for assessment of the baby's condition by drawing blood from the umbilical cord, and then maybe a transfusion to the baby if the condition is severe.
Meanwhile, you should be mentally prepared, that with such a condition in early pregnancy, there is risk to the baby.
Please act as directed by your gynecologist, and if possible, consult a fetal medicine specialist also.
Take care.
Answered: Wed, 2 Jan 2013
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