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Results for “Rh Sensitization”

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At least 217 records · Page 12Linked to original sources
PubMed1979

[On the feto-maternal transfusion of red blood cells during transplacental and para-placental genetic amniocenteses (author's transl)].

The concentrations of fetal hemoglobin (HbF) containing red blood cells in the peripheral blood of the mothers was studied in 113 cases by the method of Kleihauer & Betke prior and following trans-abdominal amniocenteses for genetic reasons between 15 and 18 weeks of pregnancy. Prior to the amniocentesis, 25% of the patients had HbF positive cells. Following the amniocentesis 36% of the patients showed HbF positive cells. In one out of six amniocenteses a measurable increase of the concentration of HbF containing red blood cells by approximately 0.22% was detected. These increases are within the limits found prior to amniocentesis and are not significant. There was no difference in the incidence and level of microtransfusions between paraplacental and transplacental amniocenteses. Because of the possibility of Rh sensitization Rh negative mothers should receive Rh immunoglobulin. None of the 112 patients had an abortion within two weeks following the amniocentesis.

Amniocentesis↗
PubMed1975

[An unusual cause of sensitization against the Rh factor].

A case of Rh-sensitization is reported which was caused by the intra-muscular injection of blood from the patient's husband during the first pregnancy as treatment for hyperemesis gravidarum. The first infant showed a mild erythroblastosis. The second infant suffered of a severe erythroblastosis. The literature is reviewed and the causes of Rhesus sensitization are discussed.

Adult↗
PubMed1998

The decline in Rh hemolytic disease: should Rh prophylaxis get all the credit?

OBJECTIVES: This study sought to quantify the magnitude of Rh disease reduction occurring secondary to Rh prophylaxis and other determinants. METHODS: Outcomes considered included maternal Rh sensitization, neonatal Rh disease, and perinatal deaths from Rh disease. Analysis was based on Poisson regression modeling of ecological data from Manitoba, Canada, and conditional probability modeling. RESULTS: The ecological analysis showed that changes in birth order and Rh prophylaxis resulted in 24% (95% confidence interval [CI] = 1% 42%) and 69% (95% CI = 61%, 76%) decreases, respectively, in Rh sensitizations (D and non-D) in Manitoba between 1963 and 1988. Rh prophylaxis and nonprogram factors were responsible for 83% (95% CI = 44%, 95%) and 78% (95% CI = 42%, 91%), respectively, of the reduction in perinatal deaths from Rh disease. Similar results were obtained with conditional probability modeling, which also provided estimates for the effects of changes in abortion rates and racial composition. CONCLUSIONS: In addition to Rh prophylaxis, changes in other determinants were responsible for an important fraction of the decline in Rh disease. These results provide a historical perspective on the conquest of Rh disease and also have important implications for public health policy, particularly in developing countries.

Erythroblastosis, Fetal↗
PubMed1978

Anti-autologous erythrocyte plaque-forming cells in pregnancy. A parameter of immunoregulatory change.

Peripheral blood leukocytes (PBL) from 16 persons (6 Rh-sensitized pregnant women, 1 pregnant non-Rh-sensitized woman, 3 nonpregnant non-Rh-sensitized women, and 6 non-Rh-sensitized males) were assayed for plaque-forming cells (PFC) against several erythrocyte targets. 6 of 7 pregnant women had PFC, whereas only 1 of 6 males had PFC to autologous red cells. Antiautologous erythrocyte PFC in all of the pregnant Rh-sensitized women as well as the 1 nonpregnant multiparous woman may be the result of alloimmunization of mothers by their fetuses during gestation. Further studies in this area would be valuable in determining not only the immune status of a mother in relation to her fetus, but also would be of value in determining the consequences of that immune status on both mother and fetus. Such information would also provide a further clue to the etiology of autoimmune disease.

Adult↗
PubMed1995

Are there options for donor-derived i.m. anti-D IgG preparations other than to prevent Rh(D) sensitization? The intravenous route.

The use of i.v. anti-Rh(D) IgG for conditions other than prevention of Rh(D) sensitization is discussed. Besides highlighting the platelet response in ATP, a putative distinctive effect on the hemorrhagic threshold is suggested. Accordingly, we have included discussion of cases of aplastic anemia, myelodysplasia, heavy chemotherapy, coagulation deficiency, and senile vascular atrophy. We have also considered attempts to replace the high-dose pooled i.v. IgG (IVIG) with the much smaller amounts of IgG present in anti-Rh(D) preparations used to prevent Rh-sensitization in pregnancy. Both Fc and variable fragments of the IgG molecule may play a role, the former potentiated by manufacture-induced IgG aggregation and the latter by donor hypersensitization. A role for IgG-anti-F(ab')2 molecules cannot be ruled out.

Blood Donors↗
PubMed1977

Rh immunoglobulin utlization after spontaneous and induced abortion.

To monitor the utilization of Rh immunoglobulin (RhIG), we reviewed the charts of 389 spontaneous and 1350 induced abortion patients treated in 1975 at a metropolitan hospital. The rate of ascertainment of Rh type was significantly higher for induced (99.6%) than for spontaneous abortion patients (95.1%) (P less than 0.001). Utilization of Rh immunoglobulin (RhIG) also was significantly higher for induced (98.9%) than for spontaneous abortion patients (80.6%) (P less than 0.001). Women at risk who did not receive RhIG after spontaneous abortion were mostly young, of low gravidity, and at gestational ages (mean 14.4 weeks) associated with substantial risks of Rh sensitization. Eradication of Rh hemolytic disease requires improvement in the system of identifying and treating patients who need prophylaxis.

Abortion, Induced↗
PubMed1989

Rhesus sensitization after midtrimester genetic amniocentesis.

In 944 Rh-negative patients who received rhesus immunoglobulin (anti-D) following genetic amniocentesis, not a single case of Rh sensitization occurred. Routine administration of a small dose (100 micrograms) of anti-D is effective in preventing Rh sensitization after midtrimester amniocentesis.

Amniocentesis↗
PubMed1976

Rh-immune globulin after amniocentesis for genetic diagnosis.

The procedure of amniocentesis during the second trimester of pregnancy for genetic diagnosis creates the potential for Rh sensitization secondary to fetomaternal bleeding. We have advised administration of Rh-immune globulin after such amniocentesis whenever the pregnancy may be Rh-incompatible. Of 56 patients who received Rh-immune globulin there has been only 1 case of Rh sensitization, which occurred in a patient who underwent a second amniocentesis 2 weeks after the first attempt without receiving a second dose of Rh-immune globulin. There have been no developmental problems detected to date which could be ascribed to Rh-immune globulin.

Adult↗
PubMed1989

Production of additional atypical alloantibodies in Rh(D)-sensitized pregnancies managed by intrauterine investigation methods.

The production of additional atypical alloantibodies by previously Rh(D)-alloimmunized antenatal patients can complicate the clinical management of both mother and fetus. The relative risks of stimulating additional antibodies following the use of intrauterine investigation methods currently used for the management of haemolytic disease of the newborn have been assessed. A significantly (P less than 0.05, X2) greater number of additional antibodies were detected during pregnancy in the group of pregnancies managed by intrauterine transfusion (IUT) (3/29) than in those managed without recourse to intrauterine investigation (0/50), although one of the patients in the IUT group produced a further antibody following a fetal blood sample but before an IUT had been carried out. The number of additional antibodies detected post-delivery was significantly greater (P less than 0.02) in pregnancies managed by intrauterine transfusion (2/10) than in those managed by fetal haematocrit determination alone (0/28).

Blood Specimen Collection↗
PubMed1977

Reduced dose of Rho(D) immune globulin following induced first-trimester abortion.

A double-blind study of women after first-trimester abortion supports the efficacy of low-dose Rho(D) immune globulin (human) in the prevention of Rh sensitization. Twenty-seven per cent of patients demonstrated a fetomaternal blood leak based on Kleihauer-Betke stains. In follow-up testing, the percentage of positive titers and the absolute titer of detectable antibody at various intervals were related to the dose of administered immune globulin. This study confirmed the possible risk of sensitization in Rh-negative postabortal women and suggests the practical use of single low-dose immune globulin preparations in prevention.

Abortion, Induced↗
PubMed1986

Fetal transfusion.

In the Rh-sensitized pregnancy, direct treatment of the fetus has been practiced for over two decades. Although Rh immune prophylaxis has markedly decreased the incidence of Rh sensitization, there are still fetal deaths due to this disease. Current management of the severe form of Rh disease includes serial transabdominal intrauterine transfusions, preterm delivery and intensive neonatal care. Heart failure in the fetus may be treated by administering medications to the mother. Ascites or pericardial effusion are easy to detect with ultrasound imaging. Digoxin and diuretics have been used to reverse the ultrasound evidence of fetal congestive heart failure. Recently, direct fetal intravascular transfusion by fetoscopy has proven effective. In some instances, hydrops fetalis appears to be reversed by such transfusions. The use of promethazine and plasmapheresis have only limited success in ameliorating the disease in the fetus.

Blood Transfusion, Intrauterine↗