ABSTRACT
Haemolytic disease of the fetus and newborn/HDFN/is a condition in which the lifespan of the fetal or newborn infants red cells is shortened by the action of maternal antibodies against antigens present on the infants red cells. The most common routes of maternal sensitization are via blood transfusion or fetomaternal hemorrhage. With the institution of antenatal Rhesus (Rh) D immunoglobulin prophylaxis, the frequency of maternal alloimmunization in Rh D-negative women has decreased significantly. The prevention and treatment of Rh D alloimmunization is a true success story in obstetrics. This article present the reasons for the persistence of the anti-D alloimmunization, protocol for the prevention and diagnosis of HDFN, immunohematological management of all pregnant women, critical titre, protocol and timing in alloimmunized pregnant women.
Subject(s)
Erythroblastosis, Fetal/blood , Erythroblastosis, Fetal/therapy , Erythroblastosis, Fetal/diagnosis , Female , Humans , Immunotherapy/methods , Infant, Newborn , Isoantibodies/blood , Pregnancy , Rh-Hr Blood-Group System/blood , Rho(D) Immune GlobulinABSTRACT
This is the clinical case of a primiparous eight month pregnant female, presenting with symptoms of pregnancy-induced acute haemolytic anaemia (haemolytic aneamia provoked by an immune mechanism, intra- and extra-erythrocyte defects, and HELLP syndrome were excluded). The anaemia progressed to become life-threatening for both the pregnant women and the foetus, which brought the following questions into consideration: diagnosis of anaemia during pregnancy; dosing of corticosteroid therapy; possibility of giving birth to a viable foetus and prognosis for next pregnancies. Owing to the inter-disciplinary efforts, the life and health of this pregnant woman were preserved, but the foetus was lost.
