ABSTRACT
【Objective】 To observe the distribution of non-ABO-HDN and its clinical relevance, so as to provide reference for clinical diagnosis and treatment. 【Methods】 A total of 287 cases of non-ABO-HDN recorded during January 2012 to August 2022 were enrolled and tested in our laboratory. The correlation between maternal history of blood transfusion, pregnancy, unexpected antibody titers, gender, ABO-HDN and transfusion therapy was analyzed by chi-square test. 【Results】 All 287 cases of non-ABO-HDN involved 13 kinds of unexpected antibodies of 6 blood group systems. Rh-HDN accounted for 96.17% (276/287), and anti-D-HDN accounted for 47.04% (135/287). The proportion of non-ABO-HDN patients without ABO-HDN requiring exchange/transfusion was significantly higher than that of non-ABO-HDN patients with ABO-HDN(P8) was significantly higher than that in the low titer group (≤8) (P<0.05). There was no significant difference in gender, mother′s history of blood transfusion, pregnancy and whether or not to exchange/transfusion (severity of illness). 【Conclusion】 Understanding the characteristics of non-ABO-HDN and the specific distribution of unexpected antibodies, the correlation between various factors and diseases and their clinical significance are conductive to timely taking necessary intervention measures and reducing the risk of complications.
ABSTRACT
Late onset HDN can present as bleeding from any site of the body but more commonly from intracranial vessels. It is diagnosed if bleeding occurs after 7th day of life with normal platelet count, prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), associated with stopping of bleeding and PT/PTTreturning to normal after giving vitamin K. Among the types of intracranial bleeding in late hemorrhagic disease of newborn, intracerebral parenchymal bleeding is least common.
ABSTRACT
Background: Urinary stones are the third most common affliction of urinary tract, exceeded only by urinary tract infections and pathological conditions of prostate (BPH and Prostate cancer). Extracorporeal Shock Wave Lithotripsy (ESWL) and Uretero-renoscopic Lithotripsy (URSL) are among various treatment options available. Aims and Objectives:To compare ESWLand URSLprocedural and post procedural characteristics including outcome. Methods: A Prospective study was conducted in the department of Urology, SKIMS, on 100 patients with proximal Ureteric stone, from September 2015 to July 2017.By random selection, fifty patients were subjected to ESWL and another fifty to URSL. Various parameters were recorded on preformed proforma designed for the comparative study. Results: In our study, Parameters like Age and Gender distribution, symptoms at presentation and duration of symptoms, number of stones, laterality of stones (right/left) and grade of Hydronephrosis or Hydroureteronephrosis were uniformly distributed in the two groups (URSL VS ESWL). Spinal anaesthesia (SA) or General Anaesthesia(GA) was required in URSL group only, while as local anaesthesia and sedation was required in some patients in ESWLgroup. 72% and 88% patients achieved stone clearance in ESWLand URSLgroup respectively, (p=0.046). DJ stent was used in 20% of URSL patients and none in ESWL group. Procedure time was relatively less for URSL (p=0.001). Although statistically insignificant, Post procedure hematuria and urosepsis were higher in URSL group, where as pain/colic and fever was slightly higher in ESWL group. Steinstrasse was significantly higher in ESWL group (p=0.008). Hospital stay was significantly higher in URSL group (p<0.001). Cost involvement was higher in ESWLgroup (p=0.016). Conclusion: Although ESWL is regarded as the preferred choice of treatment for upper Ureteric stone, URSL is a safe alternative, with an advantage of obtaining an earlier or immediate stone free status in patients with stone size >10mm. In patients with smaller stones (<10mm), ESWL may be considered a reasonable alternative to URSL.
ABSTRACT
Objective For the second children diagnosed as ABO hemolytic disease of the newborn(ABO-HDN),we made a comprehensive analysis of the related indicators of prenatal and postpartum,so as to achieve early prevention,early diagnosis and early treatment.Methods Prenatal microcolumn gel assay was used to detect the father and mother's blood type and mother's irregular antibody,mother serum IgG anti A(B)anti-body titer.Microcolumn gel assay was used to detect hemolysis three tests after the production of pregnant women.The results were divided into five groups according to the results of hemolysis three tests:group A[di-rect antiglobulin test(+),free antibodies test(+)and antibody releasing test(+)],group B[direct antiglobu-lin test(-),free antibodies test(+)and antibody releasing test(+)],group C[direct antiglobulin test(+), free antibodies test(-)and antibody releasing test(+)],group D[direct antiglobulin test(-),free antibod-ies test(-)and antibody releasing test(+)]and group E[direct antiglobulin test(+),free antibodies test (-)and antibody releasing test(-)].Total bilirubin,unbound bilirubin,hemoglobin,reticulocyte percentage and lactate dehydrogenase were detected by automatic analyzer.Results ABO-HDN children hemolysis three tests,in the 5 groups,the higher the titer of the mother's IgG anti A(B)antibody,the more serious the child' s condition was,the difference was statistically significant(P<0.05).Reticulocyte percentage and lactate de-hydrogenase in the five groups,the difference was statistically significant(P<0.05).Conclusion A combina-tion of antenatal and postnatal multiple laboratory test parameters is more accurate in predicting the second child ABO-HDN.At the same time,it helps to master the state of the disease and reduce the occurrence of complications and sequelae.
ABSTRACT
Objective To study the feasibility of detecting fetus RhD type gene by Surface Plasmon Reso-nance(SPR)technology,and to establish a new rapid diagnosis method for fetus RhD type gene.Methods The different types of DNA corresponding RNA probes were fixed on the surface of SPR chip by using amino cou-pling methods,and optimize the chip analysis condition,and then using the RNase H enzyme hydrolysis,signal amplification detection,at last the detection conditions were determined.We use the RhD type gene exon 5,7 of RNA probe to test its corresponding DNA molecules,and analyse the specificity and sensitivity of SPR chip detection signal.Results The SPR technique for detecting the exon 5,7 of RhD blood type gene shows good sensitivity and specificity in all,SPR technology can specifically detect the Exon 5,7 of RhD blood type gene, and the sensitivity of for detecting RhD gene exon 5,7 is 100 pmol/L by SPR.Conclusion The SPR technolo-gy can quickly detect RhD gene accordingly,SPR technology is simple,rapid,reliable and label-free,w hich can provide a new way predicting fetal RhD type for RhD negative prenatal.
ABSTRACT
[Objective] To investigate the relevant factors of neonatal hemolysis, especial y the association between maternal health and neonatal hemolysis. [Methods]O and Rh positive pregnant women in late pregnancy in 497 cases, make physical identification, and track whether the newborn hemolysis. [Results] There were significant differences in different physical pregnant women in the postpartum hemolysis newborn during pregnancy, the partial repletion heat, phlegm dampness postpartum hemolytic disease of the newborn was a high incidence of pregnancy, the lowest incidence rate and quality of postpartum hemolytic disease of the newborn. [Conclusion]The constitution(partial phlegm, partial heat) pregnant women for health care, to achieve peace and reduce neonatal ABO hemolytic was significant.
ABSTRACT
Objective To study the early diagnosis of heamolytic disease of newborn(HDN) by umbilical blood immunoserological test. Methods According to the laboratory rules, immunoserological tests were practised with neonatal umbilical blood of 916 A or B blood-type neonates delivered by O-type blood mothers. The morbidity and the pathogenic time of hyperbilirubinemia were studied in 7 days after birth to the neonates whose erythrocyte was sensitized by the anti-A(B) IgG. Results (1) There was significant difference in the morbidity of hyperbilirubinemia of the neonates whose umbilical blood antibody-released test results were postive compared with control group (P<0.01), There had no significant difference in the morbidity of hyperbilirubinemia of the neonates compared with puerperal times. (2) There had significant difference in the morbidity of hyperbilirubinemia between the neonates having free antibody and those without free antibody (P < 0.01). (3) The peek time of hyperbilirubinemia was in 1-3 days after birth in patient-infants whose antibodyreleased test result was positive. Conclusion The umbilical blood immunoserological test is an exact method of the early diagnosis to HDN. The free antibody helps to estimate the developing trend of HDN.
ABSTRACT
The very rare D--/D-- phenotype lacks C, c, E, e antigens with strong expression of the D antigen. A 31-year-old woman delivered her second baby, 3.6 kg girl at 38+4 weeks' gestation through repeat-Cesarean section. Her parents were not consanguineous. She had one artificial abortion, one Cesarean section with red blood cell transfusion and two spontaneous abortions. Her red cells were typed as O, D+C-c-E-e- and did not react with anti-Hr(o) (Rh 17). Her serum reacted with all of the screening cells and identification panel cells with strength of (++)~(+++). The baby was mildly jaundiced 12 hours after delivery. At 1 day after delivery, total bilirubin was 17.7 mg/dL, and direct and indirect antiglobulin tests were both positive. Phototherapy was immediately given for the baby but jaundice and anemia were worsened. Twenty six milliliter of the mother's whole blood was given twice to the baby after plasma depletion and leukocyte reduction. The baby showed improvement of jaundice and anemia, and discharged at hospital day 14. As far as we know, this is the third reported case of hemolytic disease of the newborn occurred in the D--/D-- mother with anti-Hr(o) in Korea, and the first case that was neither fatal nor treated with intensive medical care.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Pregnancy , Abortion, Spontaneous , Anemia , Bilirubin , Cesarean Section , Coombs Test , Erythrocyte Transfusion , Hepatitis B e Antigens , Jaundice , Korea , Leukocytes , Mass Screening , Mothers , Parents , Phenotype , Phototherapy , PlasmaABSTRACT
0.05).⑵ With the increase of titers of anti-A(B) antibodies of IgG type, both the incidence and severity of HDN elevated (P
ABSTRACT
BACKGROUND: Since the introduction of anti-Rh immunoglobulin prophylaxis, the incidence of hemolytic disease of the newborn (HDN) due to anti-D has remarkably decreased while the number of HDN due to ABO antibodies or minor blood group antibodies remains same. In Caucasians, anti-c, anti-E and anti-K are antibodies most frequently implicated in HDN. But in Koreans, antigenic frequency of Rh or Kell blood group is very different from Caucasians, so it is expected that the frequency of antibodies causing HDN would also be very different. Because there has been no representative data on minor blood group antibodies causing HDN in Korea, we analyzed 79 antibodies associated with HDN. METHODS: From January 1989 to July 1998, we determined the antibody specificity causing HDN in 79 cases. The nature and in vitro characteristics of the antibodies were analyzed. RESULTS: Among 79 cases, ABO antibodies were responsible in 20 cases, and anti-D was responsible in 7 cases. In minor blood group incompatibility, anti-E+c (21 cases) and anti-E (18 cases) antibodies were the antibodies most commonly involved. In ABO incompatibility, Direct Coombs' test (DAT) on baby RBC was positive only in 65% (13/20 cases). In 13 cases, ABO antibodies were detected only in the eluate of baby RBC. In non-ABO incompatibility, 96.6% (57/59 cases) showed positive DAT. In cases associated with anti-E+c and anti-E, Rh subtypes of 20 mothers were all CCDee except one, and Rh subtypes of 12 babies were all CcDEe except one. CONCLUSION: In ABO-HDN, negative DAT was frequently found and the test on baby RBC eluate was an essential part for diagnosis. Among non-ABO incompatibility, Rh incompatibilities, including RhD, were responsible in 94.9% (56/59 cases). Among HDN due to minor blood group antibodies, in contrast to previous reports, we found that anti-E+c was the most common antibody involved in HDN.
Subject(s)
Humans , Infant, Newborn , Antibodies , Antibody Specificity , Blood Group Incompatibility , Coombs Test , Diagnosis , Immunoglobulins , Incidence , Korea , MothersABSTRACT
Objective Study on fetomaternal immuno state and RHD type of a pregnant woman of weak D phenotype.MethodsThrough polymerase chain reaction (PCR)、direct genomic DNA sequencing and flow cytometry.ResultsIn both sequence specific promer (SSP) PCR and the sequencing PCR tests, the sample was detected negative in exons 3 6 of the RHD gene, whereas all other exons (exons 1 2,7 10) were tested positive. And the sequence of detected exons (exons 1 2,7 10) are the same with normal RHD in GenBank (accession no. AJ299020 1 and AJ299026 9). Serologically and genetically, the sample can be designated as D category VI type Ⅲ. Through a duce tube PCR method, the RhD zygosity of this individual was typed CD VI e/cde。In flow cytometry, a few fetal erythrocytes were detected in peripheral blood of the mother. However there were no anti D detected in sera and hemolytic disease of the newborn(HDN) observed at all.ConclusionSevere cases of HDN have occurred in D positive babies born to partial D mother with anti D, although HDN don't take place in this case. We may still consider D VI phenotype individuals as D positive donors and D negative receiptions in our transfusion practice and in clinical anti D allo immune prophylaxis and monitoring.