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Prenatal with +DAT


David Saikin

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Looking for ramifications for the unborn . . .

19 y.o. Prenatal studies: B Positive; all 3 screening cells 2+ in gel. Dat: IgG (gel): 1+, anti-C3b,-C3d: 0.

Abid: panagglutinin, reactions range from 1+ - 2+. Elution: panagglutinin, reactions: all 4+. Autoabsorption: negative. Repeated one month later: same scenario. Ortho cells react; other panels @ 0.8% are negative neat but 1-2+ if ficin pretreated. Pt LDH is low normal. Tube testing is all negative.

I guess I am looking to see if this IgG will affect the unborn. No history of anything autoimmune (I specifically asked about Lupus).

Any insights will be graciously accepted.

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You might ask about high blood pressure, if you haven't already. I've read that Aldomet is becoming more popular again for treating hypertension in pregnancy. It certainly has a long history for causing pos DATs, along with other meds for high blood pressure. Whether it causes problems for baby, I don't know, but I'll bet there were studies done.

That said, we had a prenatal panel within the last year with problems very similar to your patient's. We requested a redraw in a month and saw the same reactions, with no change in strength of reactions. The patient was Grav 1. She apparently had no underlying illnesses. She was taking no meds, though she was using a cream for 'skin problems'. The person I got her history from couldn't tell me the name of the cream - they apparently didn't think it important enough to write down the name. I have wondered whether her skin problem was an autoimmune problem, which maybe was related to the DAT ???? The OB doc was not concerned and the patient and baby did fine. This practice is large, and gets plenty of referrals for high risk pregnancy, so they see all kinds of interesting cases, but I don't think this patient was considered a problem case. Guess she will remain a mystery.

Edited by AMcCord
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