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https://www.readbyqxmd.com/read/29318985/a-randomised-controlled-trial-and-economic-evaluation-of-intraoperative-cell-salvage-during-caesarean-section-in-women-at-risk-of-haemorrhage-the-salvo-cell-salvage-in-obstetrics-trial
#1
Khalid S Khan, Philip Moore, Matthew Wilson, Richard Hooper, Shubha Allard, Ian Wrench, Tracy Roberts, Carol McLoughlin, Lee Beresford, James Geoghegan, Jane Daniels, Sue Catling, Vicki A Clark, Paul Ayuk, Stephen Robson, Fang Gao-Smith, Matthew Hogg, Louise Jackson, Doris Lanz, Julie Dodds
BACKGROUND: Caesarean section is associated with blood loss and maternal morbidity. Excessive blood loss requires transfusion of donor (allogeneic) blood, which is a finite resource. Cell salvage returns blood lost during surgery to the mother. It may avoid the need for donor blood transfusion, but reliable evidence of its effects is lacking. OBJECTIVES: To determine if routine use of cell salvage during caesarean section in mothers at risk of haemorrhage reduces the rates of blood transfusion and postpartum maternal morbidity, and is cost-effective, in comparison with standard practice without routine salvage use...
January 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29274715/no-133-prevention-of-rh-alloimmunization
#2
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
#3
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...
December 17, 2017: Transfusion
https://www.readbyqxmd.com/read/29207719/approach-to-a-pregnant-woman-with-anti-d-anti-c-reactivity-pattern-a-diagnostic-conundrum
#4
Preeti Rai, Geetika Sharma, Deeksha Singh, Jyoti Garg
The Rhesus G antigen is present on all RBCs that are C+ and also on most D+ RBCs. Due to this co-distribution of G with either C or D antigen, it mimics a reactivity pattern of anti C + anti D on Indirect Antiglobulin Test (IAT), though the role of Anti G in causing Hemolytic Disease of Newborn (HDN) is controversial. The differentiation of anti D, anti C, and anti G is essential particularly in pregnant females. We hereby report a rare case of anti G with anti D and anti C in a pregnant woman with emphasis on approach to identify anti D+C+G and its implications...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29193117/the-development-of-d-antibodies-after-d-mismatched-kidney-transplantation-in-a-setting-of-reduced-immunosuppression
#5
Thomas H P M Habets, Joris Vanderlocht, Ron J M H E Straat, Tim C van Smaalen, Gerard M J Bos, Erik A Beckers, Maarten H L Christiaans, Yvonne M C Henskens
BACKGROUND: D antigens are not taken into account in the allocation of solid organs. Female transplant recipients with D antibodies as a consequence of D-mismatched kidney transplantation may develop hemolytic disease of the fetus and newborn in future pregnancies. We examined D antibody development in transplant recipients who received D-mismatched kidney transplantation in absence of D prophylaxis and in a setting of reduced immunosuppression. STUDY DESIGN AND METHODS: From 1993 until 2015, a total of 1355 kidney patients received transplantations in our center of whom 156 received a D-mismatched graft...
November 29, 2017: Transfusion
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
#6
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)...
November 29, 2017: Transfusion
https://www.readbyqxmd.com/read/29192961/the-incidence-and-outcome-of-clinically-significant-antibodies-detected-in-rhesus-d-positive-pregnant-women-of-the-northern-territory
#7
Lauren Andersson, Ferenc Szabo
BACKGROUND: Haemolytic disease of the fetus/newborn secondary to clinically significant non-Rhesus-D antibodies has risen in importance since the advent of immunoprophylactic anti-D administration to Rhesus-D negative women. Of interest is the incidence of these antibodies in Rhesus-D positive women, who receive less frequent antenatal alloantibody screening. This is of particular concern if the antibodies arise late in pregnancy and may go undetected. AIMS: To assess the proportion of Rhesus-D positive pregnant women with late developing clinically significant antibodies for haemolytic disease of the fetus/newborn, and whether these resulted in adverse fetal outcomes...
November 28, 2017: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29096879/non-invasive-fetal-rhd-genotyping-for-rhd-negative-women-stratified-into-rhd-gene-deletion-or-variant-groups-comparative-accuracy-using-two-blood-collection-tube-types
#8
Catherine A Hyland, Glenda M Millard, Helen O'Brien, Elizna M Schoeman, Genghis H Lopez, Eunike C McGowan, Anne Tremellen, Rachel Puddephatt, Kirsten Gaerty, Robert L Flower, Jonathan A Hyett, Glenn J Gardener
Non-invasive fetal RHD genotyping in Australia to reduce anti-D usage will need to accommodate both prolonged sample transport times and a diverse population demographic harbouring a range of RHD blood group gene variants. We compared RHD genotyping accuracy using two blood sample collection tube types for RhD negative women stratified into deleted RHD gene haplotype and RHD gene variant cohorts. Maternal blood samples were collected into EDTA and cell-free (cf)DNA stabilising (BCT) tubes from two sites, one interstate...
October 30, 2017: Pathology
https://www.readbyqxmd.com/read/29096422/non-invasive-fetal-rhd-genotyping-of-rhd-negative-pregnant-women-for-targeted-anti-d-therapy-in-australia-a-cost-effectiveness-analysis
#9
Louisa G Gordon, Catherine Hyland, Jon Hyett, Helen O'Brien, Glenda Millard, Robert Flower, Glenn Gardener
To undertake a cost-effectiveness analysis of non-invasive fetal RHD genotyping to target pregnant women for antenatal anti-D prophylaxis therapy. METHOD: A decision-analytic model was constructed to compare RHD testing and targeted anti-D prophylaxis, with current universal anti-D prophylaxis among pregnant women with RhD negative blood type. Model estimates were derived from national perinatal statistics, published literature, donor program records and national cost sources. One-way sensitivity analyses addressed the uncertainty of variables on the main findings...
November 2, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29076164/nonhemolytic-passenger-lymphocyte-syndrome
#10
S Gerald Sandler, Suhua Han, Albert Langeberg, Cal Matsumoto, Thomas M Fishbein
BACKGROUND: An 8-month-old recipient of a liver segment transplant had anti-D detected for the first time in her Day 5 posttransplant plasma and anti-C detected for the first time in her Day 55 posttransplant plasma. The donor's plasma contained anti-C and anti-D. Clinical and laboratory findings established a diagnosis of passenger lymphocyte syndrome (PLS). Hemolysis did not occur, because the recipient's blood group phenotype was, by chance, D- C-. STUDY DESIGN AND METHODS: To evaluate contemporary practice for diagnosing PLS, we conducted a retrospective 10-year literature review...
October 26, 2017: Transfusion
https://www.readbyqxmd.com/read/29071816/application-of-multiplex-ligation-dependent-probe-amplification-assay-for-genotyping-major-blood-group-systems-including-del-variants-in-the-d-negative-korean-population
#11
Banseok Kim, Seung Tae Lee, Sinyoung Kim, Jong Rak Choi, Hyun Ok Kim
BACKGROUND: The DEL blood type, a very weak D variant, is a major concern in the field of transfusion medicine because of its potential to cause anti-D alloimmunization. We investigated the molecular basis of serologically D-negative phenotypes, including the DEL type, and the distribution of other blood group systems in the Korean population using the recently developed multiplex ligation-dependent probe amplification (MLPA) assay. METHODS: Blood group genotyping using the MLPA assay and RhCE phenotyping were performed on randomly selected 95 D-negative red blood cell products...
January 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29053863/a-case-of-a-newborn-with-blocked-rhd-antigen-and-hdfn
#12
Haijuan Wang, Jian Chen, Yongmei Jiang
A group O RhD-negative pregnant patient with anti-D antibody at titer 1:2048 delivered a baby boy by cesarean section at 38 + 6 weeks gestational age. The neonate typed as group O, but D antigen was at first uncertain. DAT and antibody screen of newborn were both positive. Various assays were used for D antigen determination. Ultimately, D antigen blocked by high-titer maternal anti-D antibody was confirmed. Total bilirubin of the newborn was 52.7 umol/L, and hemoglobin was 1.46 mg/dL. O RhD-negative red cells were used for an exchange transfusion...
November 8, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29046203/-clinical-effect-of-anti-d-immunoglobulin-in-treatment-of-childhood-immune-thrombocytopenia-a-meta-analysis
#13
Wei Qin, Shao-Ling Huang, Ting-Ting Li
OBJECTIVE: To investigate the clinical effect and safety of anti-D immunoglobulin (anti-D) in the treatment of children with newly diagnosed acute immune thrombocytopenia (ITP) through a Meta analysis. METHODS: PubMed, EMBASE, Cohrane Library, Ovid, CNKI, and Wanfang Data were searched for randomized controlled trials (RCTs) published up to April 2017. Review Manager 5.3 was used for the Meta analysis. RESULTS: Seven RCTs were included. The Meta analysis showed that after 72 hours and 7 days of treatment, the intravenous immunoglobulin (IVIG) group had a significantly higher percentage of children who achieved platelet count >20×10(9)/L than the anti-D group (P<0...
October 2017: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29043831/del-phenotype
#14
Dong H Kwon, S G Sandler, Willy A Flegel
DEL red blood cells (RBCs) type as D- by routine serologic methods and are transfused routinely, without being identified as expressing a very weak D antigen, to D- recipients. DEL RBCs are detected only by adsorption and elution of anti-D or by molecular methods. Most DEL phenotypes have been reported in population studies conducted in East Asia, although DEL phenotypes have been detected also among Caucasian individuals. Approximately 98 percent of DEL phenotypes in East Asians are associated with the RHD*DEL1 or RHD*01EL...
September 2017: Immunohematology
https://www.readbyqxmd.com/read/28970689/the-prozone-effect-exerted-by-the-complement-binding-anti-le-a-on-anti-d
#15
Sanmukh R Joshi, Kamlesh H Parekh
BACKGROUND: Prozone phenomenon is seen with very high-titer antibodies in an immune serum. AIM: The prozone effect on anti-D by a low-titer anti-Le(a) was investigated associated with neonatal jaundice. MATERIALS AND METHODS: Standard methods were used in investigations. RESULTS: The child was born at full-term developed mild jaundice. With weak direct antiglobulin test+, her indirect serum bilirubin was progressed to 27...
July 2017: Asian Journal of Transfusion Science
https://www.readbyqxmd.com/read/28952672/long-term-follow-up-of-patients-with-spontaneous-clearance-of-hepatitis-c-does-viral-clearance-mean-cure
#16
M Iqbal, P A McCormick, M Cannon, N Murphy, P Flanagan, J E Kennelly, L Thornton
Up to 40% of patients with hepatitis C virus (HCV) antibodies are negative for HCV RNA at initial evaluation. If there is a risk of viral re-activation, long term follow-up is required with attendant financial, psychological and medical implications. We investigated the risk of re-activation in the Irish anti-D cohort. Information was obtained from the national hepatitis C database which includes data on patients infected by anti-D immunoglobulin in two large outbreaks, 1977-9 and 1991-94. As part of a screening programme, starting in 1994, 64,907 females exposed to anti-D immunoglobulin were evaluated...
June 9, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28948523/enhanced-stability-of-gold-magnetic-nanoparticles-with-poly-4-styrenesulfonic-acid-co-maleic-acid-tailored-optical-properties-for-protein-detection
#17
Xiaomei Zhang, Qinlu Zhang, Ting Ma, Qian Liu, Songdi Wu, Kai Hua, Chao Zhang, Mingwei Chen, Yali Cui
Gold magnetic nanoparticles (GoldMag) have attracted great attention due to their unique physical and chemical performances combining those of individual Fe3O4 and Au nanoparticles. Coating GoldMag with polymers not only increases the stability of the composite particles suspended in buffer but also plays a key role for establishing point-of-care optical tests for clinically relevant biomolecules. In the present paper, poly(4-styrenesulfonic acid-co-maleic acid) (PSS-MA), a negatively charged polyelectrolyte with both sulfonate and carboxylate anionic groups, was used to coat the positively charged GoldMag (30 nm) surface...
September 25, 2017: Nanoscale Research Letters
https://www.readbyqxmd.com/read/28926139/the-synonymous-nucleotide-substitution-rhd-1056c-g-alters-mrna-splicing-associated-with-serologically-weak-d-phenotype
#18
Sejong Chun, Jae Won Yun, Geon Park, Duck Cho
BACKGROUND: D antigen is one of the most clinically significant blood group antigens. Variation of the RHD gene can cause weak D or partial D phenotypes. While most variations are missense substitutions with amino acid changes, those without are called "silent" or "synonymous" substitutions. Synonymous substitutions often have little effect on the protein, not altering the phenotype. However, effect on splicing can affect end-product protein. We report a new synonymous variation, RHD 1056C>G, that resulted in weak D phenotype, and predicted its effect with various in silico methods...
September 19, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28923311/colorimetric-detection-of-d-dimer-in-a-paper-based-immunodetection-device
#19
Sónia Ruivo, Ana M Azevedo, Duarte M F Prazeres
A microfluidic paper-based analytical device (μPADs) immunoassay for detection of the blood native biomarker D-dimer is reported. The μPAD is created by wax printing on a single piece of chromatographic paper and combined with an anti-D-dimer capture antibody and conjugates of anti-D-dimer antibody with 40 nm gold nanoparticles. The presence of D-dimer in buffer/simulated plasma samples is successfully reported for concentrations as low as 15 ng D-dimer/mL. Linearity between signal intensity and D-dimer concentration is observed up to 100 ng/mL...
September 15, 2017: Analytical Biochemistry
https://www.readbyqxmd.com/read/28893486/-anti-d-prophylaxis-in-fetal-maternal-erythrocyte-incompatibility-in-tunisia
#20
I Ksibi, R Achour, W Bel Haj Ammar, M Cheour, M Ben Amara, K Neji, S Kacem
Generalization of postnatal prophylaxis using anti-D immunoglobulins decreased the incidence of erythrocyte fetal-maternal incompatibility (EFMI) in the Rhesus system. Few recent studies have investigated the situation of anti-D prophylaxis in Tunisia and its effects on maternal and neonatal health. The aim of this study was therefore to analyze the situation of anti-D prophylaxis in Tunisia to detect defects and propose solutions. We conducted a retrospective descriptive study of IFME cases in the rhesus system in the Department of Medicine and Neonatal Resuscitation of the Tunis Maternity and Neonatology Center (CMNT) during an 8-year period from 1 January 2006 to 31 December 2015...
September 8, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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