AbstractThe Winnipeg Rh Laboratory has reviewed its experiences with maternal Cwalloimmunization. From September 24, 1956, to March 31, 1992, 12 women with significant Cwalloimmunization underwent 18 pregnancies. In 3 (4 pregnancies) the antibody, despite its strength, was ‘naturally occurring’ (i.e. there was no known exposure to Cw‐positive red cells). The remaining 9 women (14 pregnancies) had Cw‐positive husbands. Two had Cw‐negative babies and a third infant, probably Cwnegative, was stillborn and macerated at 43 weeks gestation. Eleven babies were Cwpositive and had hemolytic disease of the newborn (HDN), with antiglobulin‐positive red cells. Five did not require treatment; 2 needed phototherapy only, and 4 (born between 1956 and 1963) required exchange transfusions. No anti‐Cwscreening was carried out until 1977; thereafter it was sporadic, 11 of 51 screening red cells being Cwpositive in the 39‐month period ending March 31st, 1992. From November 1, 1977, to March 31, 1992, 24 women (30 pregnancies, 31 conceptuses) with insignificant anti‐Cwalloantibodies were identified. Extrapolating these figures to the entire period from September 24, 1956, to March 31, 1992, we estimate that at least 430 women (at least 573 pregnancies) were Cwalloimmunized, most of the antibodies being ‘naturally occurring’. Only 2 of the conceptuses were Cwpositive and affected; none were severely affected. Anti‐Cwis relatively common, occurring in about 1 pregnant Manitoban woman in 1,100. On very rare occasions (11 times in Manitoba in 36 years and 5 months) anti‐CwHDN occurs which, although not severe, may end in kernicterus with brain damage or neonatal death unless it is detected promptly
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