DETECTION OF TRACE AMOUNTS OF FETAL RHD-POSITIVE RED-CELLS WITH FLOW-CYTOMETRY AFTER MULTIPLE RH-NEGATIVE INTRAUTERINE TRANSFUSIONS AND RHD-GENE DETERMINATION WITH PCR

In 2 cases of RhD-sensitized women, hemolytic disease of the newborns (hdn) was mitigated by intrauterine transfusions of O Rh-negative dono r blood during pregnancy In both cases preterm delivery was performed by cesarean section in week 32 of pregnancy. With cord blood the direc t antiglobulin test (DAT) was negative using the gel test. The blood g roups corresponded to the transfused donor blood. With now cytometry ( FC), 2% of IgG coated red cells were found in the cord blood in case 1 and 5% in case 2. Using FC, these cells were RhD positive. Polymerase chain reaction (PCR) analyses showed the presence of RhD-gene sequenc es in both cases. Therefore, FC and PCR seem to be suitable methods fo r the diagnosis and the monitoring in cases of imminent hemolytic dise ase due to anti-D alloimmunization. With further transfusions, both ch ildren developed well after delivery.