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  3. Rh antibody titre test

What is Rh Antibody Titre test?

Rh is a protein that is present on the surface of the red blood cells. Most people are RH positive - they have RH on their RBCs. Those who don’t have this protein are called RH negative.

Just like the ABO blood groups, RH is its own blood grouping system. An RH positive person cannot donate blood to an RH negative person. If they do, the recipient’s body would make specific antibodies against the RH protein and would cause a transfusion reaction in the recipient, which could be fatal in extreme cases.

RH compatibility is a major concern in pregnant women. When an Rh-negative woman is pregnant with an Rh-positive baby, her immune system recognises the Rh protein from the baby’s blood as a foreign body and produces antibodies against it.

(Read more: RH sensitisation during pregnancy symptoms)

Though the first baby may not have any serious effects from these antibodies the mother’s body will remember RH protein as a threat and would produce a more severe reaction if she gets pregnant with Rh-positive baby again. Rh antibodies can cross the placenta and destroy the baby’s red blood cells, leading to severe health conditions.

(Read more: Blood group test)

  1. Why is an Rh Antibody Titre test performed?
  2. How do you prepare for an Rh Antibody titre test?
  3. How is an Rh Antibody Titre test performed?
  4. Rh Antibody Titre test results and normal levels

Why is an Rh Antibody Titre test performed?

Rh antibody titres are ordered to pregnant women who are tested positive for the presence of Rh antibodies.

While the woman may not show any symptoms related to Rh incompatibility. Her baby may have the following conditions:

  • Haemolytic anaemia: It is a condition caused due to the rapid destruction of red blood cells. Some of the symptoms of haemolytic anaemia are:  
  • Large abdomen
  • Lack of energy
  • Jaundice (yellow colouration of the skin and white part of the eyes)
  • Pale skin
  • Fast breathing
  • Fast heart rate
  • Hydrops fetalis: It is a condition in which fluid accumulates in various parts of the body. Some of the symptoms observed are as follow:
    • Excess fluid in stomach, lungs or scalp
    • Big liver, spleen or heart
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How do you prepare for an Rh Antibody titre test?

This test does not need any specific preparation. Fasting is not required either.

How is an Rh Antibody Titre test performed?

A laboratory technician will obtain a blood sample from a vein in your arm in the following manner:

  • He/she will tie a tourniquet (an elastic band) around your upper arm and ask you to tighten your fist. This will help them locate the right vein for sample withdrawal.
  • A sterile needle attached to a small test tube will be inserted into the vein, and a small amount of blood will be drawn.
  • The needle will be removed, and the technician will cover the site of injection with a bandage.
  • He/she will then label the sample and send it to the laboratory for testing.

The whole procedure requires less than three minutes to complete. After the test, you may get a bruise at the needle insertion site. Though it will subside on its own. Talk to your doctor if the discomfort persists or if you notice an infection. 

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Rh Antibody Titre test results and normal levels

Normal results:

A normal test result will be reported as compatible, i.e., no Rh antibodies are found.

Abnormal results:

A titre higher than 1:4 indicates Rh incompatibility (Rh alloimmunisation).

An antibody titre level of less than or equal to 1:8 can easily be managed by checking a mother’s antibody levels. However, if the titre values are 1:16 or higher, it is necessary to check the health of the baby.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. American College of Obstetricians and Gynecologists (ACOG) Committee on Practice Bulletins. Obstetrics. ACOG Practice Bulletin No. 181: Prevention of Rh D alloimmunization. Obstetrics & Gynecology. 2017;130(2):e57-70.
  2. American College of Obstetricians and Gynecologists [internet], Bethesda (MD). US; The Rh Factor: How It Can Affect Your Pregnancy
  3. Stanford Children's Health: Lucile Packard Children's Hospital. Stanford. USA; Rh Disease
  4. Wilson D. McGraw-Hill’s Manual of Laboratory & Diagnostic Tests. 2008. The Mc Graw Hills companies Inc., pp 104,105.
  5. Cremers GE, et al. Attitudes toward placentophagy: A brief report. Health Care for Women International. 2015;35:113. PMID: 23862735.
  6. American College of Obstetricians and Gynecologists [internet]. Bethesda (MD). US; Bleeding During Pregnancy
  7. Cacciatore Alessandra, et al. Obstetric management in Rh alloimmunizated pregnancy. J Prenat Med. 2009 Apr-Jun; 3(2): 25–27. PMID: 22439037.
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Rh Incompatibility
  9. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Rh Disease
  10. Costumbrado J, Mansour T, Ghassemzadeh S. Rh Incompatibility. [Updated 2019 Jun 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan
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