[Immuno-hematological follow up of pregnant women]

Immuno-hematological follow up of pregnant women. The goal of immuno-hematological follow-up during pregnancy is to organize maternal transfusion safety and optimal management of fetal and neonatal hemolytic disease, that may result from maternal immunization. This follow-up relies on scheduled antibodies detection following regulation. Since May 2017 the refund by social security of the fetal RHD genotyping analysis on maternal plasma, it is possible to limit prophylaxis of allo-immunization to RhD-negative women with a RhD positive fetus. If red blood cell antibody detection is positive, an identification and a quantification of the antibody must be performed. Furthermore, fetomaternal red blood cell incompatibility must be confirmed, in order to adapt the management of allo-immunized pregnancy, for detection of fetal anemia but also to anticipate possible transfusion requirements of the mother and the newborn long before delivery.