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Results for “Rh Isoimmunization”

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At least 127 records · Page 7Linked to original sources
PubMed1990

Placental transfer of cefazolin and piperacillin in pregnancies remote from term complicated by Rh isoimmunization.

Although the administration of prophylactic antibodies for intrauterine transfusion is controversial, little information is available regarding placental transfer of antibiotics administered to the mother, or whether the presence of hydrops affects this placental transfer. Sixteen intravascular intrauterine transfusions were performed in 10 patients. Seven (10 procedures) patients were given 2 gm of cefazolin before the procedure and samples were obtained by fetal vascular access. Three patients (six procedures) were given 4 gm of piperacillin and samples were similarly obtained. Specimens were obtained for fetal serum, maternal serum, and amniotic fluid antibiotic concentration. The mean serum cefazolin concentration in hydropic fetuses was 18.04 +/- 3.37 micrograms/ml, and in nonhydropic fetuses the concentration was 21.02 +/- 17.8 micrograms/ml (p = 0.72). The mean fetal serum concentration of piperacillin was 22 +/- 12 micrograms/ml. The placental transfer of both drugs was similar. We conclude that the transplacental passage of these antibiotics is prompt and that the presence of hydrops does not significantly impair the passage of cefazolin.

Blood Transfusion, Intrauterine↗
PubMed1981

Rh isoimmunization: a 24 year experience at Duke University Medical Center.

A retrospective analysis was made of Rh-sensitized patients delivered of their babies at Duke University Medical Center during a 24 year period. Records of 202 obstetric patients representing 280 sensitized pregnancies from a pool of 39,910 deliveries were analyzed for past obstetric history, blood group information, antibody determinations, amniocentesis data, and details of the pregnancy and delivery. The medical records of the corresponding infants were analyzed for their neonatal course. A severity index (SI) was devised to classify the degree of severity of the erythroblastosis fetalis. A significant correlation between SI and the delta OD450 of amniotic fluid, umbilical cord hematocrit, and bilirubin was noted. The evaluation of amniotic fluid delta OD450 is considered to be the cornerstone of clinical management. Twenty-nine patients had initial Liley zone 1 determinations which decreased to delta OD450 = 0.000; however, only 10 of 29 (34.5%) of the infants were unaffected, and 13 of 29 (44.8%) had mild sensitization, four of 29 (13.8%) had moderate sensitization, and two of 29 (6.9%) had severe sensitization. The previously held concept of "critical titer" as a guide for initiating amniocentesis is challenged, and the recommendation is made that amniocentesis for amniotic fluid determination should be undertaken in any patient with a positive indirect Coombs titer.

Adolescent↗
PubMed1980

[Severe Rh-isoimmunization and intensive plasma exchange during pregnancy].

Intensive plasma exchange was performed with a continuous-flow centrifuge in 2 pregnant women severely immunized to the Rh(D) iso-antigen. Plasma exchange was started at 17 and 18 weeks of gestation and a total of 220 litres and 185 litres plasma was replaced with plasma protein fraction over a period of 14 and 12 weeks respectively. There was a marked lowering of the anti-D antibody concentration in one patient, and the expected increase in antibody level during pregnancy was prevented in the other. Serum IgG and IgA levels were decreased by the exchange, but the continuous hypogammaglobulinaemia had no adverse effects. The serum IgM concentration was also lowered, but plasma levels returned to normal between plasma exchange procedures. The successful outcome in both cases suggests that intensive plasma exchange may reduce fetal haemolysis and that it may be an useful adjunct to amniocentesis, intra-uterine transfusions and premature delivery in the prenatal management of haemolytic disease in newborn infants.

Adult↗