OBJECTIVE:To review cases of anti -c isoimmunization and determine the most appropriate management strategies.METHODS:We performed a review of 102pregnancies managed at The Ohio State University from 1967to 2001for anti -c isoimmunization.Of these,55had complete data and are included in this report.Information collected included serum titers,△OD 450 values,Liley zones,fetal and neonatal hemoglobin levels and a ntigen typing,neonatal direct antiglobulin test,and neonatal outcomes.The appropriateness of traditional management was then e-valuated.RESULTS:Of the 55pregnan cies,46had fe-tuses with positive direct antiglob ulin test,and nine preg-nancies had unaffected fetuses.Of t he affected neonates,12(26%)had serious hemolytic disease of the newborn.Of these 12,8required fetal transfu sion,and the remain-ing 4newborns had hemoglobin levels of less than 10g /dL at the time of delivery.A titer of 1:32or greater or the presence of hydrops fetalis identified all such fetuses.There were 58amniocenteses perform ed for△OD 450 .When plotted on modified Liley graph s,△OD 450 values corresponded to disease severity.T here were no perinatal deaths attributable to anti -c hemolytic disease of the newborn.CONCLUSION:Anti -c isoimm unization might cause significant fetal and newborn hemolytic disease.A titer of 1:32or greater or evidence o f hydrops fetalis i-dentified all the serious hemolytic disease at our institu-tion.The significance of antibody t iters and△OD 450 values was similar to Rh -D sensitize d pregnancies,and management by the same modalities is appropriate.
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