Diagnostic et suivi biologiques des allo-immunisations anti-érythrocytaires chez la femme enceinte

The red blood cells alloimmunizations in pregnancy are rare situations but can have serious consequences for the fetus and the newborn. The identification of these immunizations must be done during pregnancy and not urgently face to complications of fetal anemia or postnatal hyperbilirubinemia. The diagnosis of feto-maternal incompatibility (FMI) is biological, based on a well conducted biological monitoring : respect during pregnancy of recommendation for antibodies screening and titration or dosage of these antibodies. According to the type of antibody, its concentration or its titration and the term of pregnancy, a biological monitoring scheme will be develop and if necessary a clinical follow-up will be introduced to anticipate medical and technical means to follow the pregnancy. Moreover, the advances in molecular biology have improved the diagnosis of these FMI including the non-invasive diagnosis of incompatibilities, the fetal blood group genotyping from maternal blood for RHD and KELL genes. Finally the diagnosis of erythrocyte FMI and the success of their treatment based on a multidisciplinary dialogue between biologists specialized in perinatal immunohematology, obstetricians and neonatologists.