[Status of Kell incompatibility in a 15-year retrospective study of mother-child serology in clinical records].

Abstract

The frequency and clinical relevance of anti-Kell antibodies is reported based upon 80,509 antibody screenings in pregnant women over a period of 15 years. The pedigrees of two families involved in Kell-incompatibilities illustrate the sometimes tragic outcome of these pregnancies. Seven Kell-incompatibilities in the course of 134 pregnancies in 43 women with anti-Kell antibodies have been serologically verified. Three led to stillbirths, one to neurologic defects, another to jaundice without permanent clinical consequences and two babies had to undergo exchange transfusions but are healthy today. The Kell-selected transfusion strategy practised in our center was derived from our observations on the mode of sensitization. Protection against Kell-sensitization in cases of ABO-incompatible mother-child constellations, as well as possible protective effects of Rh-prophylaxis are discussed. Failure to recognize the problem or delay in serologic diagnosis are the most serious problems facing the Kell-incompatible pregnancy.