Reconsidering Routine Repeat Group and Screens During Pregnancy-Personalizing Pregnancy Care

Ann Tran; Gwen Clarke; Jeannie L Callum; Graeme Smith; David Somerset; Julie Thorne; Lani Lieberman

doi:10.1016/j.jogc.2024.102351

Reconsidering Routine Repeat Group and Screens During Pregnancy-Personalizing Pregnancy Care

J Obstet Gynaecol Can. 2024 Jan 8;46(5):102351. doi: 10.1016/j.jogc.2024.102351. Online ahead of print.

Authors

Ann Tran¹, Gwen Clarke², Jeannie L Callum³, Graeme Smith⁴, David Somerset⁵, Julie Thorne⁶, Lani Lieberman⁷

Affiliations

¹ Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC. Electronic address: ann.tran2@fraserhealth.ca.
² Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC; Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, AB.
³ Department of Pathology and Molecular Medicine, Kingston Health Sciences Centre, Queen's University, Kingston, ON; Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.
⁴ Department of Obstetrics and Gynaecology, Kingston Health Sciences Centre, Queen's University, Kingston, ON.
⁵ Department of Obstetrics and Gynecology, University of Calgary, Calgary, AB.
⁶ Department of Obstetrics and Gynaecology, Women's College Hospital, Sinai Health Systems and University of Toronto, Toronto, ON.
⁷ Laboratory Medicine Program, University Health Network, Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON.

PMID: 38199432
DOI: 10.1016/j.jogc.2024.102351

Abstract

The group and screen (G&S) are performed in early pregnancy to identify clinically significant antibodies (CSA) that may necessitate fetal monitoring for hemolysis/anemia or affect RhIg eligibility. Guidelines vary, including differences between RhD-positive and negative patients, but typically, the G&S is repeated at 28 weeks, and sometimes pre-delivery. We reviewed data showing a low risk (0.01%-0.43%) of detecting a new CSA in late gestation (late alloimmunization) and the risk of late alloimmunization causing severe hemolysis/anemia is even lower at <0.01%. Routinely repeating a G&S at 28 weeks and delivery may not be necessary for healthy, low-risk pregnancies.

Keywords: blood banks; hemolytic anemia; prenatal care.