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Identification of anti-erythrocyteantibodies in pregnant women's blood comparison of different methods of antibody titre testing (column gel agglutination method and test tube method)
TICHÁ, Markéta
The discovery of blood flow and new blood systems was connected with the development of the immunohematology methods.The blood flow was discovered in the 17th century.This meant great scientific development for haematology.The first blood transfusion was carried out in1665.The transfusion of animal blood was unsuccessful and cast doubt on this method.As a result of this,the interest in this method decreased.Blundell emphasizedthe importance of human blood transfusion.The main reason for failure of first transfusions was the ignorance of blood types(blood groups).The blood types were discovered in the 20th century.The blood groups became well known thanks to Landsteiner and also to Jánský.The first discovered blood system is AB0.It is the most important blood system which was described by Landsteiner in1900.The most polymorphous system which has got the biggest aloimmunogenicity is the Rh blood group system.The first records of the Rh blood group system date back to1939.The discovery of blood group systems had a great impact on further development of lab methods for identification of the antigens of these systems.It also contributed to the development of methods which we use to prove the presence of the erythrocytes antibodies.Agglutinin method is the most suitable method for identification of antibodies against erythrocytes.Erythrocytes which are sensitized by antibody create agglutination which can be observed under a microscope.Pregnant women produce antibodies against antigens on the erythrocytes of embryos leak of erythrocytes into their blood flow.Testing of antierythrocyte antibodies should lead to early diagnoses of possible development of haemolytic disease of the newborns;to monitoring of embryo with the use of other method than immunohaematological method;to determination of the suitable therapy of the haemolyticdisease of the newborn.The haemolytic disease of the newborn is a disease,for which shortened survival of the embryo's and the newborn'serythrocytes is characteristic.In1939 Levin a Stetson proved that woman can be immunised during her pregnancy against blood group antigens which occur on baby'serythrocytes but aren't present at the mother's side.Mother's antibodies are tied to specific antigens of the fetal and newborn erythrocytes,which later haemolyse.The disease can have different course.It causes serious fetal and newborn morbidity and mortality.Especially the antibodies anti-D,-c,-E,-K can cause serious haemolytic disease of the newborn and requirecareful monitoring.Only IgG with low molecular weight penetrate through placenta(until the 24th week of pregnancy very slowly).The introduction of anti-D Ig(given prophylactically)became a very common and successful method for prevention of haemolytic disease of the newborn.The theme of this thesis is the examination and monitoring of potentially risk group of pregnant women,whose embryo is threatened by possible haemolytic disease of the newborn,with the use of suitable immunohaematological method.Titre testing is generally accessible indicative testing,which is used to monitor pregnant women with clinically significant level of antibodies.The level of antibodies in a blood sample measured using the antibody titre test is repeatedly monitored during the whole pregnancy and the results from every two successive measurements are compared.Between Jan 2011-Jul 2013 5622pregnant women were tested in prenatal laboratory in the Blood Bank Department of Hospital České Budějovice.281pregnant women were aloimmunized during their pregnancy and antibodies against antigens on erythrocytes of their embryos were found in their blood.All women were tested using the method of column gel agglutination,including antigen titre testing.In 31samples of pregnant women the antibody titre was tested using the test tube method.
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