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PubMed2006

Prevalence of new maternal alloantibodies after intrauterine transfusion for severe Rhesus disease.

Limited information is published on the frequency of new maternal alloantibodies found in patients treated for isoimmunization. The purpose of this study was to determine the prevalence of additional maternal red cell alloantibodies, found after the initiation of treatment for Rhesus (Rh) disease. A retrospective review of all patients treated for severe Rh disease was undertaken. Rh disease requiring intrauterine blood transfusion was defined as severe. Gravidas with alloantibodies in addition to Rh were included, but those without Rh antibodies were excluded. New alloantibodies were defined as antibodies absent in previous pregnancies and on initial pregnancy screening, and found after the onset of invasive treatment. There were a total of 84 intrauterine blood transfusions performed in 31 gravidas with severe Rh disease. Seven patients (23%) were found to develop additional red cell alloantibodies after treatment during the pregnancy. Induction of additional maternal red cell alloantibodies after treatment for severe Rh disease is relatively common. This may have significant implications for future pregnancies in this high-risk population.

Antibody Formation↗
PubMedDate not supplied

[Assess flow velocity in the ductus venosus and inferior vena cava in fetuses in isoimmunized pregnancies].

OBJECTIVE: Ductus venosus and inferior vena cava flow velocity was assessed in fetuses in isoimmunized pregnancies. METHODS: Examination of 61 fetuses aged 27 to 35 weeks from Rh-erythrocyte antigen isoimmunized women was carried out from June 1999 to June 2004. All fetuses were submitted to the examination of ductus venosus and inferior vena cava flow velocity. Blood samples were collected to determine hemoglobin values and hemoglobin concentration deficits. Accordingly, fetuses were grouped as follows: non-anemic; mildly anemic; moderately anemic and severely anemic fetuses. Comparison of the variation of average flow velocity in the inferior vena cava and ductus venosus across the four groups was carried out using the chi-square test. RESULTS: Inferior vena cava flow velocity was found to be altered in 3.8% of non-anemic fetuses; in 3.1% of the mildly anemic, in 40.0% of those moderately anemic; and in 76.0% of the severely anemic ones. Alteration in ductus venosus flow velocity, in turn, was identified in 7.7% of non-anemic fetuses; 3.1% of mildly anemic; 32.5% of moderately anemic and 68.0% of those severely anemic. Results were statistically significant with p < 0.001. CONCLUSION: The study shows that alteration of flow velocity in the inferior vena cava and ductus venosus increased with the severity of anemia.

Adult↗
PubMed1978

Rh antibodies produced by an isoimmunized chimpanzee; reciprocal relationship between chimpanzee simian-type isoimmune sera and human anti-Rho reagents.

An isoimmune chimpanzee serum was found to contain, in addition to expected antibodies of the simian-type specificity anti-Lc, a fraction of anti-Rho specificity, as proved by parallel tests with standard human anti-Rho sera as well as by absorption experiments using human and chimpanzee red cells. On the other hand, the two human anti-Rho sera tested in parallel were found to contain not only antibodies of specificity anti-Rho but also antibodies capable of detecting Lc specificity on the chimpanzee red cells. The reciprocal relationship between human and chimpanzee isoimmune sera constitutes the first example of symmetrical cross-reactivity between closely related species. The new source of anti-Rho reagents is expected to contribute additional information on the human Rh-Hr blood group system.

Animals↗
PubMed1995

Fetal venous, arterial, and intracardiac blood flows in red blood cell isoimmunization.

OBJECTIVE: To investigate the effect of anemia on fetal venous, arterial, and intracardiac blood flows. METHODS: Color flow Doppler was used to record flow-velocity waveforms from the atrioventricular valves, ductus venosus, right hepatic vein, inferior vena cava, middle cerebral artery, and descending thoracic aorta from 38 cases of red blood cell isoimmunized pregnancies. Immediately after the Doppler studies, funipuncture was performed and the fetal hemoglobin concentration was measured. RESULTS: Blood flow velocities in the thoracic aorta, middle cerebral artery, and the ductus venosus were increased compared to reference ranges established previously; however, a significant association with the degree of anemia was found only for the velocity in the thoracic aorta. Pulsatility indices in arteries and veins and the ratio of early to late atrioventricular inflow velocities were not significantly different from normal. CONCLUSIONS: Fetal anemia is associated with a hyperdynamic circulation in both arterial and venous vessels. Even in severe anemia, there is no evidence of congestive heart failure. Venous and intracardiac Doppler studies do not provide a clinically useful contribution in the management of red blood cell isoimmunization.

Anemia↗