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Fetal alloimmunization

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https://www.readbyqxmd.com/read/29780649/sonographic-demonstration-of-intracranial-hemorrhage-in-a-fetus-with-hydrops-fetalis-due-to-rh-alloimmunization-after-intrauterine-intravascular-transfusion-a-case-report-and-review-of-the-literature
#1
Rauf Melekoglu, Ebru Celik, Hasim Kural
Intrauterine transfusion is the most common and successful intrauterine procedure for the treatment of fetal anemia due to red cell alloimmunization. Fetal intracranial hemorrhage is a very rare complication of intrauterine transfusion in patients with Rh(D) alloimmunization and it has been demonstrated only in a few case reports in the literature. Herein, we described a case of grade IV intraventricular hemorrhage that was diagnosed following the first intrauterine transfusion and reviewed the literature about the fetal intracranial hemorrhage that occurred after intrauterine intravascular transfusion procedure...
2018: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29732576/transfusions-of-least-incompatible-blood-with-intravenous-immunoglobulin-plus-steroids-cover-in-two-patients-with-rare-antibody
#2
Nay Win, Malcolm Needs, Nicole Thornton, Robert Webster, Cherry Chang
BACKGROUND: The therapeutic value of the use of intravenous immunoglobulin (IVIG) to correct anemia and thrombocytopenia as a result of immunologic causes (hemolytic disease of the fetus and newborn and fetal or neonatal alloimmune thrombocytopenia) have been well established. Few published papers exist regarding the use of IVIG in adult settings. We report two patients with clinically significant antibodies against high-incidence antigens, who were successfully transfused with incompatible red blood cells (RBCs), in conjunction with IVIG plus steroids and IVIG...
May 6, 2018: Transfusion
https://www.readbyqxmd.com/read/29730660/perinatal-outcome-and-long-term-neurodevelopment-after-intracranial-haemorrhage-due-to-fetal-and-neonatal-alloimmune-thrombocytopenia
#3
Dian Winkelhorst, Marije M Kamphuis, Sylke J Steggerda, Monique Rijken, Dick Oepkes, Enrico Lopriore, Jeanine M M van Klink
OBJECTIVES: To evaluate the perinatal and long-term neurodevelopmental outcome in a cohort of children with intracranial haemorrhage (ICH) due to fetal and neonatal alloimmune thrombocytopenia (FNAIT) and to clearly outline the burden of this disease. SUBJECTS AND METHODS: We performed an observational cohort study and included all consecutive cases of ICH caused by FNAIT from 1993 to 2015 at Leiden University Medical Centre. Neurological, motor, and cognitive development were assessed at a minimum age of 1 year...
May 4, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29669341/management-and-neonatal-outcomes-of-pregnancies-with-fetal-neonatal-alloimmune-thrombocytopenia-a-single-center-retrospective-cohort-study
#4
Stefania Ronzoni, Johannes Keunen, Prakeshkumar S Shah, Edmond N Kelly, Rory Windrim, P Gareth Seaward, Greg Ryan
BACKGROUND: There is no consensus regarding the optimal antenatal treatment of fetal/neonatal alloimmune thrombocytopenia (F/NAIT). We aimed to review the fetal blood sampling (FBS)-related risk, fetal response to maternal intravenous immunoglobulin (IVIG), and cesarean section (CS) rate in pregnancies with a history of F/NAIT. METHODS: Maternal demographics, alloantibodies, pregnancy management, fetal and neonatal outcomes, and index case characteristics were collected...
April 18, 2018: Fetal Diagnosis and Therapy
https://www.readbyqxmd.com/read/29624682/abo-incompatibility-and-rhig-immunoprophylaxis-protect-against-non-d-alloimmunization-by-pregnancy
#5
Carolien Zwiers, Joke M Koelewijn, Lisa Vermij, Joost van Sambeeck, Dick Oepkes, Masja de Haas, C Ellen van der Schoot
BACKGROUND: Hemolytic disease of the fetus and newborn (HDFN) is caused by maternal antibodies against fetal red blood cell antigens, most often anti-D, -K, or -c. ABO incompatibility between mother and child and anti-D immunoprophylaxis (RhIG) are known to reduce the risk of D immunization and subsequent HDFN. However, no immunoprophylaxis has been developed to prevent non-D immunizations. STUDY DESIGN AND METHODS: We evaluated whether ABO incompatibility has a preventive effect on formation of non-D alloantibodies, by performing a case-control study including pregnant women with newly detected non-D antibodies, identified within a nationwide data set, immunized during their first pregnancy and/or delivery...
April 6, 2018: Transfusion
https://www.readbyqxmd.com/read/29610181/neonatal-alloimmune-thrombocytopenia-with-amegakaryocytosis-b-lymphopenia-and-villitis
#6
Arthur Dony, Annie Buenerd, Corinne Pondarre
Neonatal alloimmune thrombocytopenia (NAIT) is a common but significant challenge for neonatologists and a potentially devastating disease that may lead to intracranial bleeding. The underlying mechanism of thrombocytopenia is expected to be mediated by accelerated clearance of antibody-opsonized fetal platelets. We report severe recurrent NAIT related to human platelet antigen (HPA)-15 systems in 2 consecutive siblings. The first child presented with intracranial hemorrhage at birth and subsequently died. The diagnosis of NAIT, although initially suspected, was ruled out after negative investigation of only HPA-1, HPA-3, and HPA-5 systems...
April 2018: Pediatrics
https://www.readbyqxmd.com/read/29603363/transfusion-related-adverse-events-are-decreased-in-pregnant-women-with-sickle-cell-disease-by-a-change-in-policy-from-systematic-transfusion-to-prophylactic-oxygen-therapy-at-home-a-retrospective-survey-by-the-international-sickle-cell-disease-observatory
#7
Jean-Antoine Ribeil, Myriam Labopin, Aurélie Stanislas, Benjamin Deloison, Delphine Lemercier, Anoosha Habibi, Souha Albinni, Caroline Charlier, Olivier Lortholary, François Lefrere, Mariane De Montalembert, Stéphane Blanche, Frédéric Galactéros, Jean-Marc Tréluyer, Eliane Gluckman, Yves Ville, Laure Joseph, Delville Marianne, Alexandra Benachi, Marina Cavazzana
Sickle cell disease (SCD) in pregnancy can be associated with adverse maternal and perinatal outcomes. Furthermore, complications of SCD can be aggravated by pregnancy. Optimal prenatal care aims to decrease the occurrence of maternal and fetal complications. A retrospective, French, two-center study compared two care strategies for pregnant women with SCD over two time periods. In the first study period (2005-2010), the women were systematically offered prophylactic transfusions. In the second study period (2011-2014), a targeted transfusion strategy was applied whenever possible, and home-based prophylactic nocturnal oxygen therapy was offered to all the pregnant women...
March 30, 2018: American Journal of Hematology
https://www.readbyqxmd.com/read/29512164/maternal-red-blood-cell-alloimmunization-requiring-intrauterine-transfusion-a-comparative-study-on-management-and-outcome-depending-on-the-type-of-antibody
#8
Thanh-Vy Phung, Véronique Houfflin-Debarge, Nassima Ramdane, Louise Ghesquière, Anne Delsalle, Capucine Coulon, Damien Subtil, Pascal Vaast, Charles Garabedian
BACKGROUND: The antibody primarily responsible for fetal anemia may influence treatment and prognosis. The primary objective was to compare ante- and postnatal management and the outcomes of maternal red blood cell (RBC) alloimmunizations according to the antibody involved. The secondary objective was to compare anti-D alloimmunizations according to associated number of antibodies. STUDY DESIGN AND METHODS: A single-center study from 1999 to 2015 including maternal RBC alloimmunizations requiring intrauterine transfusion (IUT) was conducted...
May 2018: Transfusion
https://www.readbyqxmd.com/read/29499991/the-effects-of-gestational-alloimmune-liver-disease-on-fetal-and-infant-morbidity-and-mortality
#9
Sarah A Taylor, Susan Kelly, Estella M Alonso, Peter F Whitington
OBJECTIVES: To evaluate pregnancy outcomes in pedigrees of neonatal hemochromatosis to determine the spectrum of gestational alloimmune liver disease (GALD) in a large cohort. STUDY DESIGN: We prospectively collected data from women with a prior offspring with proven neonatal hemochromatosis between 1997 and 2015 and analyzed pregnancy outcomes. RESULTS: The pedigrees from 150 women included 350 gestations with outcomes potentially related to GALD...
May 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29476829/management-of-red-blood-cell-alloimmunization-in-pregnancy
#10
REVIEW
L Ghesquière, C Garabedian, C Coulon, P Verpillat, T Rakza, B Wibaut, A Delsalle, D Subtil, P Vaast, V Debarge
The main cause of fetal anemia is maternal red blood cell alloimmunization (AI). The search of maternal antibodies by indirect antiglobulin test allows screening for AI during pregnancy. In case of AI, fetal genotyping (for Rh-D, Rh-c, Rh-E and Kell), quantification (for anti-rhesus antibodies) and antibody titration, as well as ultrasound monitoring, are performed. This surveillance aims at screening for severe anemia before hydrops fetalis occurs. Management of severe anemia is based on intrauterine transfusion (IUT) or labor induction depending on gestational age...
May 2018: Journal of gynecology obstetrics and human reproduction
https://www.readbyqxmd.com/read/29470342/acog-practice-bulletin-no-192-management-of-alloimmunization-during-pregnancy
#11
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29470338/acog-practice-bulletin-no-192-summary-management-of-alloimmunization-during-pregnancy
#12
(no author information available yet)
When any fetal blood group factor inherited from the father is not possessed by the mother, antepartum or intrapartum fetal-maternal bleeding may stimulate an immune reaction in the mother. Maternal immune reactions also can occur from blood product transfusion. The formation of maternal antibodies, or "alloimmunization," may lead to various degrees of transplacental passage of these antibodies into the fetal circulation. Depending on the degree of antigenicity and the amount and type of antibodies involved, this transplacental passage may lead to hemolytic disease in the fetus and neonate...
March 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29451309/antibodies-to-human-neutrophil-antigen-hna-3b-implicated-in-cases-of-neonatal-alloimmune-neutropenia
#13
Larissa Barbosa Lopes, Samira Ali Abbas, Elyse Moritz, Juliana Oliveira Martins, Akemi Kuroda Chiba, Dante Mário Langhi, José O Bordin
BACKGROUND: Neonatal alloimmune neutropenia results from maternal alloimmunization to human neutrophil antigens. The alloantibodies involved in neonatal alloimmune neutropenia are against human neutrophil antigens HNA-1a, HNA-1b, HNA-1c, HNA-1d, HNA-2, HNA-3a, HNA-4a, HNA-4b, and HNA-5a; however, to date, antibodies specific to HNA-3b have not been reported. STUDY DESIGN AND METHODS: Blood samples from 10,000 unselected neonates were analyzed, resulting in the selection of 88 neutropenic newborns (neutrophil count <1...
May 2018: Transfusion
https://www.readbyqxmd.com/read/29412452/screening-for-fetal-and-neonatal-alloimmune-thrombocytopenia-lessons-learned-from-a-norwegian-screening-program
#14
LETTER
Mette Kjaer, Jens Kjeldsen-Kragh, Cathrine Fiskum, Irene Leinan, Bjørn Skogen, Anne Husebekk
No abstract text is available yet for this article.
February 7, 2018: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/29378146/anti-vel-alloimmunization-and-severe-hemolytic-disease-of-the-fetus-and-newborn
#15
Kenneth J Moise, Yisel Morales, Marsha F Bertholf, Susan N Rossmann, Yu Bai
Only rare cases of anti-Vel-associated mild-to-moderate hemolytic disease of the fetus and newborn have been previously reported. No case of fetal anemia requiring prenatal therapy has been noted to date. We report such a case recently encountered at our Fetal Center. Strategies are discussed for managing pregnancy complicated with alloimmunization to an antibody to a high-prevalence antigen, including sources of red blood cells for intrauterine transfusions.
December 2017: Immunohematology
https://www.readbyqxmd.com/read/29306729/adding-to-the-complexity-of-fetal-and-neonatal-alloimmune-thrombocytopenia-reduced-fibrinogen-binding-in-the-presence-of-anti-hpa-1a-antibody-and-hypo-responsive-neonatal-platelets
#16
E Refsum, S Meinke, G Gryfelt, A Wikman, P Höglund
BACKGROUND: In fetal and neonatal alloimmune thrombocytopenia (FNAIT), maternal alloantibodies directed against paternally-derived platelet antigens are transported across the placenta to the fetus, where they may cause thrombocytopenia. The most serious complication of FNAIT is an intracranial hemorrhage (ICH), which may cause death or life-long disability of the child. Apart from alloantibody-mediated platelet destruction, the clinical outcome in FNAIT may be affected by properties of neonatal platelets and possible functional effects on platelets caused by maternal alloantibodies...
February 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29274715/no-133-prevention-of-rh-alloimmunization
#17
Karen Fung Kee Fung, Erica Eason
OBJECTIVE: To provide guidelines on use of anti-D prophylaxis to optimize prevention of rhesus (Rh) alloimmunization in Canadian women. OUTCOMES: Decreased incidence of Rh alloimmunization and minimized practice variation with regards to immunoprophylaxis strategies. EVIDENCE: The Cochrane Library and MEDLINE were searched for English-language articles from 1968 to 200 I, relating to the prevention of Rh alloimmunization. Search terms included: Rho(D) immune globulin, Rh iso- or aile-immunization, anti-D, anti-Rh, WinRho, Rhogam, and pregnancy...
January 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29250791/successful-management-of-severe-red-blood-cell-alloimmunization-in-pregnancy-with-a-combination-of-therapeutic-plasma-exchange-intravenous-immune-globulin-and-intrauterine-transfusion
#18
Laura C Nwogu, Kenneth J Moise, Kimberly L Klein, Hlaing Tint, Brian Castillo, Yu Bai
BACKGROUND: Antibodies to Rhesus and Kell antigens have been associated with severe hemolytic disease of the fetus and newborn (HDFN) necessitating intrauterine transfusion (IUT) of red blood cells (RBCs). We report a case series of five women with severe HDFN secondary to maternal RBC alloimmunization who were successfully managed with therapeutic plasma exchange (TPE), intravenous immune globulin (IVIG), and IUT. STUDY DESIGN AND METHODS: This is a retrospective case series of five women with severe HDFN who underwent a total of three TPE procedures during Weeks 10 to 13 of pregnancy, followed by weekly IVIG infusions...
March 2018: Transfusion
https://www.readbyqxmd.com/read/29240037/fetal-anemia-causing-hydrops-fetalis-from-an-alpha-globin-variant-homozygous-hemoglobin-constant-spring
#19
Patcharee Komvilaisak, Ratana Komvilaisak, Arunee Jetsrisuparb, Surapon Wiangnon, Junya Jirapradittha, Pakaphan Kiatchoosakun, Goonapa Fucharoen
BACKGROUND: Fetal anemia is often assumed to be due to red cell alloimmunization and Parvovirus infection, and can lead to hydrops fetalis and death in utero. Other causes, such as mutations of hemoglobin alpha, are less commonly considered. METHODS: We report 7 cases with fetal anemia causing hydrops fetalis. Serial Doppler ultrasound for measurement peak systolic velocity (PSV) of middle cerebral artery (MCA) was used for evaluation of fetal anemia. Fetal anemia is suggested if the MCA/PSV ratio is >1...
December 12, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29193111/clinical-input-of-anti-d-quantitation-by-continuous-flow-analysis-on-autoanalyzer-in-the-management-of-high-titer-anti-d-maternal-alloimmunization
#20
Cécile Toly-Ndour, Haifa Mourtada, Stéphanie Huguet-Jacquot, Emeline Maisonneuve, Stéphanie Friszer, Françoise Pernot, Pauline Thomas, Jean-Marie Jouannic, Bruno Carbonne, Anne Cortey, Agnès Mailloux
BACKGROUND: In addition to titration by indirect antiglobulin test most widely used, anti-D quantitation by continuous-flow analysis (CFA) may be performed to assess severity of maternal immunization. Only five studies have reported its added value in the management of pregnancies complicated by anti-D immunization. STUDY DESIGN AND METHODS: A retrospective study of 74 severe anti-D-immunized pregnancies was conducted from January 1, 2013, to December 31, 2014, in the Trousseau Hospital in Paris (France)...
February 2018: Transfusion
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