What precautions can be taken during pregnancy if mother is Rh-negative and ICT reports are positive?

Question

Hi,

My 33-year-old wife is 30 weeks pregnant. This is her second pregnancy. Her blood group is B negative, and my blood group is O positive. However, her ICT test got positive (value 1:8). She has been taking medicine for ulcerative colitis for four years (Mesalazine 2400 mg daily).

She is also taking calcium and iron tablets. She has normal pregnancy symptoms and normal test reports, but what treatment or precautions should be taken for ICT test reports?

Please help, doctor.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understand your concern.

When an Rh-negative woman reveals an indirect Coombs test (ICT) positive (more than 1:32 titer), then amniocentesis is performed, and the optical density of the amniotic fluid is determined by spectrophotometry (a sample of the amniotic fluid is collected from the mother with the help of a needle).

If the bilirubin level is found to be in the danger zone, as seen by plotting in the Queenan and Liley curve, then cordocentesis and fetal exchange transfusion are performed to manage these women and improve neonatal outcomes.

This is not required for your wife, as the values are mildly high. But to avoid any complications, I suggest you take the following measures-

1. Prophylactic anti-D injections around 28 weeks of pregnancy.

2. Doppler study - a simple, non-invasive technique of monitoring fetal anemia in Rh isoimmunized pregnancy.

3. Intravenous immune globulin (IVIG) helps to prevent hemolysis (if anything turns south, we have this medicine as a safety measure).

Thank you.