ABSTRACT
The evaluation of immunization by the HNA1a and 1b antigens during pregnancy was based on (i) their genotyping in 1038 unselected mothers and newborns of homozygous mothers, (ii) granulocyte counting in all born infants and (iii) examination of granulocyte antibodies in maternal sera if an HNA1 incompatibile child was born. A total of 548 (52.8%) mothers were heterozygous--thus further examinations were not done. Four hundred and ninety (47.2%) were homozygous, of whom 203 (41.3%) delivered an incompatible child, i.e. 19.6% of all the infants. Among available sera from 195 mothers with feto-maternal incompatibility, the granulocyte-specific antibodies were found in nine (4.5%); six of these (3%) were HNA1 (four anti-1a, two anti-1b), and in three others the specificity was not determined. In the remaining 28 sera, the only antibodies detected were HLA. Hence, six out of 1000 pregnant women can be expected to develop anti-HNA1. In none of the newborns was the cord neutrophil count below 1.5 x 109 L-1 and signs of infection found, thus the incidence of NAIN seems to be lower than 1 per 1000 infants. A comparison with our previous, unpublished data suggests that the incidence of severe NAIN is roughly 1 per 6000 (four cases among 24101 newborns).
Subject(s)
Isoantibodies/immunology , Isoantigens/immunology , Neutropenia/immunology , Blood Group Incompatibility , Female , Genotype , Homozygote , Humans , Infant, Newborn , Isoantigens/genetics , Leukocyte Count , PregnancyABSTRACT
The registry of donors typed for HPA-1 and HPA-3 antigens is presented. Three cases of fetal/neonatal alloimmune thrombocytopenia (F/NAIT) transfused with typed platelets either from mother or from registered donors are discussed. All children were transfused just after delivery, one in addition in utero: they survived not having any haemorrhagic complications in central nervous system inspite of such complications in previous born siblings. In the paper the general rules of platelet transfusions in F/NAIT are discussed.
Subject(s)
Antigens, Human Platelet/analysis , Blood Platelets/immunology , Fetal Diseases/therapy , Platelet Transfusion/methods , Thrombocytopenia/therapy , Fetal Diseases/immunology , Humans , Infant, Newborn , Thrombocytopenia/immunologyABSTRACT
A case of the neonatal narcotic abuse syndrome is presented. A newborn baby additionally suffered from the congenital infection. Marked symptoms of narcotic withdrawal required an administration of the opiates and tranquillizers for three weeks.
Subject(s)
Neonatal Abstinence Syndrome/diagnosis , Opioid-Related Disorders/complications , Opium/administration & dosage , Pregnancy Complications/psychology , Critical Care , Female , Humans , Infant, Newborn , Male , Maternal-Fetal Exchange , Neonatal Abstinence Syndrome/drug therapy , PregnancySubject(s)
Blood Transfusion, Intrauterine , Erythroblastosis, Fetal/therapy , Plasmapheresis , Pregnancy Complications, Hematologic/blood , Rh Isoimmunization/blood , Adult , Combined Modality Therapy , Erythroblastosis, Fetal/etiology , Female , Humans , Infant, Newborn , Pregnancy , Prenatal Care , Rh Isoimmunization/complicationsSubject(s)
Erythroblastosis, Fetal/complications , Hydrops Fetalis/etiology , Rh Isoimmunization/complications , Erythroblastosis, Fetal/blood , Erythrocyte Count , Female , Fetal Hemoglobin/analysis , Hemoglobin A/analysis , Humans , Hydrops Fetalis/blood , Infant, Newborn , Pregnancy , Rh Isoimmunization/bloodABSTRACT
The results of treatment with intrauterine transfusion are presented. The analysis comprised 48 successful transfusions into 29 foetuses. The reference group consisted of 11 transfusions which proved nonfeasible or ineffective and 54 untreated cases. Following blood treatment, the newborn mortality rate dropped more than threefold. Long-term follow-up of 21 children generally showed their good physical and mental development. We also present 4 cases of supsequent pregnancies after intrauterine blood treatment in a preceding pregnancy, showing that it is possible to save the next baby of the same mother.
