Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Rh Isoimmunization”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 649 records · Page 36Linked to original sources
PubMed2001

Risk free simultaneous prenatal identification of fetal Rhesus D status and sex by multiplex real-time PCR using cell free fetal DNA in maternal plasma.

QUESTIONS UNDER STUDY: Pregnancies with a Rhesus constellation still present a considerable obstetric problem. In addition, pregnancies with male Rhesus D fetuses are more severely affected by haemolytic disease of the newborn, requiring more transfusions in utero and having a three fold higher mortality than female Rhesus D fetuses. Furthermore, almost 150 X-linked genetic deficiencies have now been characterised, increasing the need for prenatal sex determination in pregnancies at risk for such a disorder. In order examine these two important fetal loci in a risk free manner, we have developed a novel multiplex real-time PCR assay for the analysis of extracellular fetal DNA in maternal plasma. METHODS: Cell free DNA was isolated from 34 maternal plasma samples and examined by a multiplex real-time PCR assay for the Rhesus D gene and the SRY locus on the Y chromosome. RESULTS: Our study showed that we were able to genotype 12/13 Rhesus D males correctly. All 5 Rhesus d males were correctly identified. In addition a 100% concordance was found in the 16 samples obtained from pregnancies with female Rhesus D or Rhesus d fetuses. CONCLUSIONS: By developing a novel multiplex real-time PCR assay we present the first report describing the determination of multiple fetal loci from cell free DNA in maternal plasma by these means. As this assay is suitable for automation, our data, therefore, suggest that such assays provide a good basis for the clinical examination of multiple fetal loci, in particular Rhesus D status or fetal sex, and can be performed effectively using real-time multiplex PCR assays.

DNA↗
PubMed2000

Policies and procedures related to weak D phenotype testing and Rh immune globulin administration. Results from supplementary questions to the Comprehensive Transfusion Medicine Survey of the College of American Pathologists.

OBJECTIVE: To determine and evaluate policies and procedures related to weak D phenotype testing and terminology and the administration of Rh immune globulin in selected clinical situations. Design, Setting, and Participants.-Institutions participating in the College of American Pathologists 1999 J-A Comprehensive Transfusion Medicine Survey program were asked to respond to a series of supplementary questions related to weak D phenotype testing and Rh immune globulin administration. More than 3500 institutions and transfusion services participated. RESULTS: Most supplementary questions elicited more than 3000 responses. Despite no clinical or regulatory mandate, 58. 2% of transfusion services routinely perform an antiglobulin test for the weak D phenotype in patients who test negative with anti-D reagents. Significant differences were found concerning the transfusion of blood components to patients with the weak D phenotype and the administration of Rh immune globulin to these individuals. At least one patient with the weak D phenotype with anti-D alloantibody formation was observed during a 12-month period by 31.8% of transfusion services. CONCLUSIONS: Significant variability concerning policies and procedures related to weak D typing and terminology was found in this survey. Transfusion of blood components to patients with the weak D phenotype and the administration of Rh immune globulin also demonstrated variations. Anti-D alloantibody formation by patients with the weak D phenotype may not be as rare as previously thought. Additional study related to the clinical significance of these results is warranted.

Blood Banks↗
PubMed2004

Three cases of massive fetomaternal hemorrhage presenting without clinical suspicion.

Fetomaternal hemorrhage (FMH) is a common obstetrical occurrence most often associated with small volumes of blood transferred across the placenta. Fetomaternal hemorrhage leads to alloimmunization of Rh D-negative mothers, resulting in an increased risk of hemolytic disease of the newborn. Massive FMH involving volumes of blood greater than 30 mL can cause substantial fetal morbidity and mortality. Massive FMH may present with signs and symptoms such as decreased movement, sinusoidal heart rhythms, or fetal anomalies. We present 3 cases of clinically unexpected massive FMH of 206, 88, and 155 mL. The treating clinicians were unaware of any fetal or maternal signs or symptoms of FMH until contacted by the laboratory. These cases illustrate the necessity for FMH quantitation, even in the absence of clinical suspicion. Additional studies are needed to find better ways to identify these patients in advance. Development of criteria allowing identification of patients at risk would be of benefit to both mother and baby.

Adult↗
PubMed1999

[Rh (D) alloimmunization and pregnancy. Analysis of the causes after prophylaxis introduction].

PURPOSE: Prenatal and postnatal prophylaxis of the Rh (D) haemolytic disease of the newborn have clearly reduced the number of cases but still there are alloimmunizations. PATIENTS AND METHODS: All cases detected in our Hospital in the last 24 years have been reviewed and possible causes analyzed. RESULTS: From a total of 10,332 deliveries in Rh (D) negative women we have detected 114 anti-D in 86 women. In 74 women anti-D was the only antibody and in 12 there were more antibodies. Data were managed in 3-year periods and we see a progressive decrease in the incidence of alloimmunization with a minimum of 0.03 per 1000 pregnancies in the period 89-91 and a posterior progression to an incidence of 0.12 in the last 3-year period 95-97. The causes were: pregnancies before 1970 in 31, incorrect prophylaxis in 12, despite a correct prophylaxis in 6, previous pregnancies without complete information about the prophylaxis in 13, previous transfusion in 6, previous pregnancies or transfusion in 8 and indetermined in 10. CONCLUSION: It is desirable to reduce at minimum the number of Rh (D) alloimmunizations by strictly following the prophylaxis protocols.

Erythroblastosis, Fetal↗
PubMed2000

Monoclonal antibodies to Rh D--development and uses.

Monoclonal anti-D has proved impossible to make in rodent systems. Human monoclonal anti-D has been produced using EBV transformed peripheral B cells, coupled with fusions to myeloma cell lines. More recently molecular biology techniques have been used to produce monoclonal anti-D. The range of monoclonal anti-D produced is considered. The selection of monoclonal anti-D for use as blood grouping reagents for typing donors and recipients is reviewed--all types of D positive should be typed as positive when donors are considered. However, DVI patients should be typed as D negative. Considerations for the development of monoclonal anti-D for prophylactic use are reviewed.

Animals↗
PubMed2000

Is it necessary to administer anti-D to prevent RhD immunization after the transfusion of RhD-positive platelet concentrates?

Serology for the presence of anti-D after RhD-incompatible platelet transfusions was performed in 24 RhD-negative patients with haematological disease and 59 RhD-negative patients with non-haematological disease. None of the patients were given prophylaxis with anti-D to prevent RhD immunization. Eight out of 59 (13.5%) non-haematology patients developed detectable anti-D, whereas 0 out of 24 (0%) of the haematology patients formed anti-D (P = 0.06). The risk of alloimmunization after RhD-incompatible platelet transfusions using platelet concentrates prepared by modern technical methods appears to be small in patients with haematological disease, but is significant in non-immunocompromised patients.

Adolescent↗
PubMed2002

Diagnosing hemolytic disease of the newborn.

A Rh negative, pregnant female presented to a major medical center for possible Rh alloimmunization. This female had nine previous pregnancies, including three spontaneous abortions, four live births, and two fetal demises. Because of poor prenatal care, the immunization Rh immune globulin was administered to only the first two pregnancies. After much laboratory testing and treatment, this tenth pregnancy also ended in fetal demise.

Adult↗
PubMed1992

[Clinical aspects of prenatal prevention of rhesus incompatibility].

The postnatal treatment with anti-D immunoglobulin to prevent rhesus sensitization is successful in about 90% of all rhesus-negative mothers at risk. Failures derive mostly from large fetomaternal hemorrhages during the last months of pregnancy. Studies from Canada, Great Britain and Sweden have shown that the injection of an additional dosage of anti-D during the 28th to 34th week of pregnancy results in a further 90% reduction of the failure rate. Although there is only a limited number of cases of hemolytic diseases in the newborn, the cost-effect ratio of this prophylactic treatment calculated for the Federal Republic of Germany shows not only a medical but also an economic benefit.

Antibodies, Anti-Idiotypic↗