Maternal intravenous immunoglobulin: a non-invasive treatment option for Rhesus D-sensitised women with previous adverse pregnancy outcomes

Background. Maternal intravenous immunoglobulin (IVIG) may delay the onset and severity of fetal anaemia in Rhesus D (RhD)- sensitised pregnancies, thereby minimising the need for intrauterine transfusion and its associated complications. Objective. To compare the pregnancy outcomes of RhD-sensitised women who received antenatal IVIG with those who did not receive antenatal IVIG. Methods. This was a retrospective cross-sectional analysis of RhD-sensitised women who attended the Wits Fetal Medicine Centre (Johannesburg) from 1 January 2008 to 31 May 2018. Criteria for maternal IVIG administration were: (i) previous adverse pregnancy outcome (early neonatal death, intrauterine fetal death or miscarriage related to RhD sensitisation), (ii) women with high antibody titre levels (≥1:64) in the absence of fetal anaemia; and (iii) rising antibody titre levels. Maternal antibody titre levels, pregnancy and neonatal outcomes were compared in women who received IVIG v. those who did not receive IVIG. Results. Of the 42 RhD-sensitised women, 14 received IVIG. A greater proportion of women experienced a decrease in antibody titres in the IVIG v. no-IVIG group (43% v. 11%, respectively; p=0.04). Nine of the 10 women in the IVIG group with a previous adverse pregnancy outcome had a successful pregnancy outcome following IVIG treatment. Conclusion. Maternal IVIG may provide a successful pregnancy outcome in RhD-sensitised women with previous adverse pregnancy outcomes related to Rh disease, or women with raised or increasing maternal antibody titre levels who present in the first or early second trimester

Profil épidémiologique des groupes sanguins Abo & rhésus à Kalemie (R.D. Congo). A propos de 1440 cas observés

Introduction : Les groupes sanguins ABO et Rhésus contribuent grandement à la médecine transfusionnelle. Cette étude a pour but de faire un état de lieu sur la distribution des groupes sanguins érythrocytaires ABO et rhésus dans notre milieu. Matériels et méthodes : Il s'agit d'une étude rétrospective, descriptive et monocentrique sur 1440 personnes ayant fréquentées le service de sécurité transfusionnelle de l'Hôpital Général de Référence de Kalemie de janvier à décembre 2013. Résultats : Dans le système ABO, le groupe O est le plus rencontré (61,5%) très significativement, suivi de A (18,5%), B (17,5%) et AB (2,5%) ; le A et AB concernent surtout le sexe masculin (62,4% et 77,8%) alors que le O et B sont plus observés dans le groupe féminin (54,4% et 57,1%). Les Rh(D) positifs sont en première position (97%) de façon significative et intéresse surtout les femmes (52%) alors que les Rh(D) négatifs sont plus l'apanage des hommes (83,7%). Par ordre, on a le groupe O+ (60,6%), A+ (17,5%), B+ (17%), AB+(1,9%), O- et A- (1% chacun), AB- (0,6%) et B- (0,5%). Conclusion : Les efforts doivent être fournis pour capitaliser les résultats de cette étude dans le choix du sang à conserver aux bancs de sang

Rhesus Negative Woman Transfused with Rhesus Positive Blood: Subsequent Normal Pregnancy without Anti D Production

Clinicians sometimes are confronted with the challenge of transfusing haemorrhaging Rhesus (Rh) D negative patients with Rh D positive blood to save their lives. There are concerns about alloimmunization and future haemolytic disease of the newborn in women of the reproductive age. Another fear is transfusion reaction if they receive another Rh D positive blood in future. We present a 32-year-old Rh D negative woman; who had postpartum haemorrhage in her first pregnancy and was transfused with Rh D positive blood because of unavailability of Rh D negative blood. She did not receive anti D immunoglobin but subsequently had a normal term pregnancy of an Rh positive fetus without any detectable anti D antibodies throughout the pregnancy. In life threatening situations from obstetric haemorrhage; transfusion of Rh D negative women with Rh D positive blood should be considered as the last resort

Seroprevalence of HIV and Frequencies of Haemoglobin Genotypes; ABO and Rh Blood Groups among Premarital Couples in Port Harcourt; Nigeria

Background: Premarital screening is fast gaining grounds as a pre-requisite condition for the solemnization of holy matrimony by many faith based organizations in Nigeria yet there is scanty literature on the subject.Methods: Fifty (50) premarital heterosexual couples (50 males and 50 females) were screened for the presence of human immunodeficiency virus (HIV); haemoglobin genotypes; ABO and Rh blood groups using standard laboratory procedures.Results:The prevalence of HIV in this study was found to be 2.0. The frequencies of the haemoglobin genotypes were as follows; HbAA (72); HbAS (26) and HbAC (2.0) while that of ABO and Rh blood groups were: group A (22); B (14); AB (0); 0 (64); Rh 'D' Positive (96) and Rh 'D' Negative (4.0). The distribution of these variables between the sexes was statistically significant. (?2 = 21.630; p 0.01). The frequencies of the haemoglobin genotype combinations of the intending couples were as follows; HbAA/AA (52); AA/AS (36); AA/AC (4.0) and AS/AS (8.0). This distribution pattern was also found to be highly statistically significant (? 2