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LAURA HUGHES, KAREN ROSSI, DAVID KRUGH, RICHARD O’SHAUGHNESSY, Ohio State University, Obstetrics & Gynecology, Columbus, Ohio, Ohio State University, Pathology, Columbus, Ohio OBJECTIVE: To evaluate the management and outcome of patients with antiFya alloimmunization at The Ohio State University. STUDY DESIGN: A database search conducted at The Ohio State University for patients with pregnancies complicated by only anti-Fya alloimmunization resulted in 16 patients with 18 pregnancies from 1970 to 2002. Collected information included maternal antibody titers, DOD450 values, Liley zones and neonatal hemoglobin, antigen typing, direct antiglobulin test as well as neonatal outcomes. RESULTS: A database query for patients at The Ohio State University with pregnancies complicated by anti-Fya alloimmunization resulted in 93 cases. The final data set included 18 pregnancies in 16 patients where anti-Fya was the only maternal alloantibody present and the fetus was Fya antigen positive. Maternal antibody titers alone were followed in 7 pregnancies (39%). Amniocentesis was performed in 11 pregnancies (61%), cordocentesis was performed in 2 pregnancies (11%), and intrauterine transfusion was performed 5 times in a single pregnancy (5%). Maternal antibody titers ofR32 and DOD450 values in zones IIB or III identified all fetuses/ neonates with significant hemolytic disease (2/18 = 11%). These included one fetus requiring serial fetal transfusions and a neonatal exchange transfusion and one other neonate requiring an exchange transfusion following delivery. No fetuses had hydrops and there were no deaths attributed to hemolytic disease of the fetus and newborn. CONCLUSION: Although anti-Fya alloimmunization usually causes mild hemolytic disease in the fetus and newborn, it has the potential to lead to significant hemolysis requiring transfusion therapy. Management guidelines developed for RhD sensitization are appropriate for pregnancies complicated by anti-Fya alloimmunization. |
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