Acta obstetricia et gynecologica Scandinavica · 2013
Consequences of being Rhesus D immunized during pregnancy and how to optimize new prevention strategies.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Tiblad Eleonor, Westgren Magnus, Pasupathy Dharmintra, Karlsson Anita, Wikman Agneta T
Аннотация
OBJECTIVE: To analyze the timing of Rhesus D (RhD) immunization in pregnancy and the consequences for the index pregnancy and for subsequent pregnancies to be able to optimize the design of antenatal screening and prevention programs.
DESIGN: Retrospective cohort study.
SETTING: Stockholm county, Sweden.
POPULATION: All RhD immunized pregnant women 1990-2008 before the introduction of routine antenatal anti-D prophylaxis.
METHODS: Data were collected from transfusion medicine registers and databases, medical records, the Swedish Medical Birth Register and the National Perinatal Quality Register and entered into a standardized database before analysis.
MAIN OUTCOME MEASURES: The order of pregnancy and trimester when immunization occurred and treatment of hemolytic disease of the fetus and newborn.
RESULTS: A total of 290 RhD immunized women were included in the study. In 147/290 (51%) of the women, sensitization occurred with their first-born child and in 96/290 (33%) it occurred with their second-born child. Anti-D antibodies developed during the second or third trimester in 212/290 (73%) and in 61/290 (21%) at term or after delivery. In subsequent pregnancies 56% (144/259) of the neonates required treatment for hemolytic disease of the fetus and newborn.
CONCLUSIONS: Based on our study, at least half of the cases could potentially have been avoided by routine antenatal anti-D prophylaxis in the beginning of the third trimester. To optimize the beneficial effects of new prevention programs, we propose providing anti-D prophylaxis in gestational week 28-30 selectively to all RhD-negative women with RhD-positive fetuses.
DESIGN: Retrospective cohort study.
SETTING: Stockholm county, Sweden.
POPULATION: All RhD immunized pregnant women 1990-2008 before the introduction of routine antenatal anti-D prophylaxis.
METHODS: Data were collected from transfusion medicine registers and databases, medical records, the Swedish Medical Birth Register and the National Perinatal Quality Register and entered into a standardized database before analysis.
MAIN OUTCOME MEASURES: The order of pregnancy and trimester when immunization occurred and treatment of hemolytic disease of the fetus and newborn.
RESULTS: A total of 290 RhD immunized women were included in the study. In 147/290 (51%) of the women, sensitization occurred with their first-born child and in 96/290 (33%) it occurred with their second-born child. Anti-D antibodies developed during the second or third trimester in 212/290 (73%) and in 61/290 (21%) at term or after delivery. In subsequent pregnancies 56% (144/259) of the neonates required treatment for hemolytic disease of the fetus and newborn.
CONCLUSIONS: Based on our study, at least half of the cases could potentially have been avoided by routine antenatal anti-D prophylaxis in the beginning of the third trimester. To optimize the beneficial effects of new prevention programs, we propose providing anti-D prophylaxis in gestational week 28-30 selectively to all RhD-negative women with RhD-positive fetuses.