Amniotic fluid (AF) is a complex substance essential to fetal well-being. This article reviews recent discoveries and the current understanding of the origin and circulation of AF and its nutritive, protective, and diagnostic functions. Future directions for AF research are also discussed.

Amniotic fluid: not just fetal urine anymore.

Blood Groups in Man By Dr. R. R. Race and Dr. Ruth Sanger. Pp. xv + 290. (Oxford: Blackwell Scientific Publications, Ltd., 1950.) 30s. net.

Human Blood Groups

The relationship between blood groups and disease

Although anti-RhD was once the major etiology of hemolytic disease of the fetus/newborn (HDFN), the widespread adoption of antenatal and postpartum Rhesus immune globulin has resulted in a marked decrease in the prevalence of alloimmunization to the RhD antigen in pregnancy. Maternal alloimmunization to other red cell antigens continues to play a role as the cause of fetal disease since no prophylactic immune globulins are available to prevent the formation of these antibodies. An increasing incidence of the Kell (anti-K1) antibody has been noted in the United States. Guidelines for intervention in cases of irregular red cell antibodies are limited by the bias of anecdotal reports in the literature in favor of severe cases of HFDN. Although most diagnostic protocols used in the management of the RhD-alloimmunized pregnancy can be applied in cases of non-RhD sensitization, Kell (K1 and K2) alloimmunization should be managed more conservatively.

Fetal anemia due to non-Rhesus-D red-cell alloimmunization

https://www.amjmed.com/article/0002-9343(75)90606-3/pdf

Drug-induced immune hemolytic anemia

https://onlinelibrary.wiley.com/doi/pdf/10.1111/trf.12941

It's time to phase in RHD genotyping for patients with a serologic weak D phenotype

One center's experience: the serology and drugs associated with drug-induced immune hemolytic anemia--a new paradigm.

High-throughput red blood cell antigen genotyping using a nanofluidic real-time polymerase chain reaction platform.

Objective: To evaluate the rate of seropositivity to hepatitis B and C and Human Immunodeficiency Virus (HIV) infections among children with β-thalassemia major receiving multiple transfusions in Ahmedabad, India, compared with healthy controls. Materials and Methods: The study was performed during January 2007 to January 2009 on multi-transfused children suffering with β-thalassemia major registered in the Prathama Blood Centre, Ahmedabad; Jeevandeep hospital, Ahmedabad; and Red Cross Blood Centre, Ahmedabad, and investigated for the prevalence and development of transfusion-transmitted infections. Hepatitis B surface Antigen (HBsAg), anti-Hepatitis C Virus (HCV) Antibodies (Ab), and HIV Ab were checked using a fourth-generation Enzyme-Linked Immunosorbent Assay (ELISA). Positive tests were confirmed by western blots. Healthy blood donors were used for the control group. Results: Hepatitis B surface antigen, anti-HCV Ab, and HIV Ab were positive in one of 96 (1.04%; 95% Confidence Interval (CI) = 0.17-1.3), 24 of 96 (25%; 95% CI = 11.4-14.2), and one of 96 (1.04%; 95% CI = 0.12-1.3), respectively. The rate of anti-HCV Ab was significantly higher in multi-transfused children suffering with β-thalassemia major. In thalassemia patients, the rate of positive anti-HCV Ab was significantly higher than that for positive HBsAg (P<0.001) and HIV Ab (P<0.001). Conclusion: It is concluded that HCV is the current major problem in multi-transfused children with thalassemia major and more careful pretransfusion screening of blood for anti-HCV must be introduced in blood centers.

Susan T. Johnson

Papers

It's time to phase in RHD genotyping for patients with a serologic weak D phenotype

One center's experience: the serology and drugs associated with drug-induced immune hemolytic anemia--a new paradigm.

High-throughput red blood cell antigen genotyping using a nanofluidic real-time polymerase chain reaction platform.

A prospective study for prevalence and/or development of transfusion-transmitted infections in multiply transfused thalassemia major patients

Mass-scale red cell genotyping of blood donors.