ABSTRACT
BACKGROUND: Splenic rupture in the newborn is a rare complication in erythroblastosis fetalis. There are no reports of splenic rupture in the fetus affected by hemolytic disease of the newborn. CASE: A 41-year-old gravida 3, para 2-0-0-2 with severe rhesus alloimmunization was managed with serial intrauterine transfusions resulting in fetal death after the fourth procedure. Autopsy findings revealed intra-abdominal clotted blood and splenic capsular defects consistent with splenic rupture. CONCLUSION: Fetal splenic rupture might occur in hemolytic disease of the newborn associated with splenomegaly. Acute hemodynamic changes with increased intra-abdominal pressure from intrauterine transfusion might precipitate splenic rupture. (Obstet Gynecol 2001;97:824-5.
Subject(s)
Blood Transfusion, Intrauterine/adverse effects , Erythroblastosis, Fetal/therapy , Pregnancy Complications, Hematologic/therapy , Rh Isoimmunization/therapy , Splenomegaly/etiology , Adult , Female , Fetal Death , Humans , Pregnancy , Prenatal Care , Rupture, SpontaneousSubject(s)
Erythrocytes/cytology , Hemoglobinuria, Paroxysmal/blood , Phagocytosis/physiology , Adult , Female , Humans , Middle Aged , Rosette FormationABSTRACT
Transfusion of bacterially contaminated blood products remains an overlooked problem. However, the risk of receiving a bacterially contaminated unit is greater than the combined risk of HIV-1/2, HCV, HBV, and HTLV I/II [American Association of Blood Banks Bulletin, no. 294, 1996]. Topics covered in this article include: the current incidence, clinical presentation and outcome, effective methods of detection, and ways to reduce bacterial contamination of blood products. There is no one existing strategy that can completely eliminate the risk of bacterial contamination. It is inevitable that partial solutions or combinations of methods will be implemented in the near future.
