Does anyone titer warm autoantibodies during pregnancy and if so can you share your procedure? thanks Alana

NO!  The chances of a warm auto-antibody causing clinically significant HDFN are minute, and, in any case, what cells are you going to use?

 

The other thing is that how much of the maternal auto-antibody is going to be free in here plasma, how much is going to be extra-circulatory and how much is "stuck" to her own red cells?  How are you going to get an accurate answer?

 

If you are really worried about a maternal auto-antibody affecting the baby (and DON'T WORRY, unless the auto-antibody is exceptionally strong), then MCA Doppler/ultrasound is the way to go, rather than performing a titration that will tell you precisely nothing.

Malcolm gave me that same answer a few years ago - baby was born uneventfully.  He knows his stuff !!!!!

You are allowed to say I'm useless if you want David!!!!!!!!!!!!!!!!

i don't want to

Malcolm and David, thank you. This confirmed what I thought but wanted to make sure I was correct from those who had more expertise.

Alana

Shortly before retiring my discussions with our Obstetric Consultants in our busy Maternity Department showed that whilst we agreed performing regular quantitations on maternal anti-D and anti-c antibodies was worthwhile I did manage to *almost* persuade them that titring other antibodies was  of virtually no assistance in management of the pregnancy compared to MCA Doppler/ultrasound.

We parted without a conclusion being reached.

Since I left the number of titrations has remained fairly constant but my garden is far better tended.