Pregnancy immunisation by red blood cells

This advisory report concerns pregnancy immunisation by red blood cells – the phenomenon whereby women form so-called irregular erythrocyte antibodies (IEA) against foreign blood cells (erythrocytes). In addition to pregnancy, blood transfusion can cause IEA formation. The distinction between antibodies targeting the Rhesus D antigen (D-IEA) and antibodies targeting other erythrocyte antigens (Non-D-IEA) may also be made.
IEA can lead to severe illness in the unborn or newborn child, namely haemolytic disease of the foetus and newborn (HDFN). Over the past several years, methods have been developed to prevent the formation of IEA and to detect already formed IEA. Dutch research conducted as part of the Identification and Prevention of Pregnancy Immunisation (Opsporing en Preventie Zwanger-schapsimmunisatie, OPZI) project has contributed significantly to these developments.
This advisory report addresses the following: screening for non-D-IEA, options for changing transfusion policies for young girls and women of childbearing age in order to reduce the formation of non-D-IEA, prophylaxis to prevent the formation of D-IEA and ways to ensure this treatment is only given to women who may benefit from it.