What is Indirect and Direct Coombs Testing? Whats the matter?

In the formation of the baby, the baby’s blood interacts with the mother’s blood. Direct and indirect coombs are a blood test that has a very important role in the health of babies of couples of factor RH (positive or negative blood), because it can detect antibodies in the maternal organism, being vital for the healthy growth of the child in utero before even from its conception. But and you? Do you know what direct or indirect coombs are? And do you know what it could imply in the life of the fetus that grows inside this woman’s womb? Let’s talk about it, then!

What Indirect and Direct Coombs Are For

All of us humans have different types of blood. Type A, B, AB or O and, in addition to this typing variation, there are still positive and negative factors. In fact, what we will take into consideration is not the type of blood, but the positive or negative HR of the parents of the child and the baby . The risk exists for pregnancy when the RH negative woman receives a gamete from the partner that is RH positive and then generates a baby with a positive RH factor. The incompatibility of the mother’s negative Rh with the baby’s positive RH can cause the body to create antibodies against this differentiated RH factor, which can expel the baby or cause problems such as fetal erythroblastosis.

Fetal erythroblastosis affects the second child , as the first child would not be at risk as he would not have enough antibodies to overtake the placenta. However, in the second pregnancy, these antibodies present in the mother’s body pass the placenta and destroy the baby’s red blood cells, the consequences of which will be severe, and may even lead to death.

To avoid this problem, the child should receive a negative HR factor blood transfusion to avoid further complications, such as severe anemia. This event is not uncommon and, therefore, the coombs were elaborated. The coomb test can be direct or indirect. The right side checks for the presence of antibodies in the red blood cells. The indirect checks for antibodies in the serum. It serves to detect possible incompatibilities of the organism against a certain RH factor through the anti-D antibodies present in the mother’s bloodstream.

What Does the Coombs Exam Avoid?

A woman with negative HR can suffer from fetal problems due to her husband’s HR factor only if there has been a previous pregnancy or miscarriage . Therefore, before having a new pregnancy, the woman must have a treatment against these possible antibodies. To detect antibodies, coombs come into play. The reference for direct or indirect coombs is NEGATIVE . If there is any result other than this, the woman must undergo treatment during pregnancy, between 28 and 33 weeks of pregnancy . The pregnant woman, after taking the coombs test, receives an injection of anti-D immunoglobulin.

How to proceed if it is positive?

Women who are giving birth for the first time or who have detected that the aborted baby has an RH positive factor through the coombs test, receive an injection of anti-D immunoglobulin after delivery or the curettage procedure after abortion. The injection should be given within a maximum of 72 hours, or 3 days after birth. For women who suffer recurrent miscarriages, the ideal is to have the exam of coombs indirect or direct by medical order in order to find out if this is the cause of the miscarriages. Normally, women with negative HR are referred by the doctor as soon as the first abortion occurs.

If the coombs are reactive, then she must undergo treatment for such a condition. Since 2016, Anvisa has banned treatment with the husband’s vaccine or Cross-Match, which is a vaccine created from paternal blood. Despite several controversies surrounding its use, there are reports that this vaccine helps the woman’s body to adapt to the positive RH factor and prevents future abortions or births of children with training problems. Currently, some other options are offered, such as the use of cancer drugs, for example.

The expected result that brings relief to the couple is the indirect negative coombs, and after going through so many situations as the risk of erythroblastosis and even an abortion, many women want to be sure that they will provide the best possible conditions for the pregnancy to run well and uneventfully. Thus, in addition to all the necessary care, the intake of vitamins must occur daily so that the maintenance of two organisms is guaranteed: that of the mother and that of the baby. With that in mind, Famivita has developed a complete gestational multivitamin called FamiGesta . FamiGesta contains in its composition folic acid, among other vitamins and minerals needed during pregnancy. You can purchase it here in our online store .

How the Exam is Done

The examination of coombs is done in a routine laboratory for blood tests and is collected through the arm. There is no need for any kind of preparation in advance, not even fasting. We must remember that the problem can happen if the first child has a positive RH factor in mothers with a negative RH.

If the baby’s factor is negative, it will not cause any problems for the woman in future pregnancies. The immunoglobulin anti-D vaccine is very efficient. It destroys any likelihood that antibodies will develop and eliminates the chances of the disease of the next baby.

See also: Prenatal Exams – How Important Are They?

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My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.

Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.

Dr. Alexis Hart

My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother. Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.

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