Severe fetal hemolytic disease due to anti-M alloimmunization: A case report and literature review
| Autor: | Fatemeh Golshahi, Fatemeh Rahimi Sharbaf, Mahboobeh Shirazi, Behrokh Sahebdel, Jafar Golshahi, Simon Dadoun, Soroush Aalipour, Mohammad Haddadi |
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| Jazyk: | angličtina |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Case Reports in Women's Health, Vol 42, Iss , Pp e00620- (2024) |
| Druh dokumentu: | article |
| ISSN: | 2214-9112 16737288 |
| DOI: | 10.1016/j.crwh.2024.e00620 |
| Popis: | Fetal hemolysis is caused by maternal antibodies that cross the placenta. Anti-M antibodies can rarely cause severe forms of alloimmunization in the fetus and newborn. We present a case of severe anti-M alloimmunization requiring a total of 8 intrauterine transfusions, in a patient with a prior poor obstetrical history. A 35-year-old Iranian pregnant woman with a prior obstetrical history of one abortion and two stillbirths was found to have had anti-M antibody titers 1:8 and accompanying elevated middle cerebral artery peak systolic velocity (MCA-PSV) of 1.9 MoM suggestive of severe fetal anemia at 17 weeks of gestation. Persistently elevated fetal MCA-PSV was noted despite intraperitoneal transfusion at 17, 19, and 22 weeks. Fetal blood sampling at 27 weeks confirmed severe fetal anemia (3 g/dL), which required additional intravascular and intraperitoneal blood transfusion. At 37 weeks, elective cesarean section was performed. Neonatal hemoglobin immediately after delivery was 10.1 g/dL. In addition to standard supportive care, the neonate required two additional transfusions and remained in the neonatal intensive care unit (NICU) for 23 days.Anti-M antibodies are a rare cause of severe alloimmunization. We present a case in order to improve management. |
| Databáze: | Directory of Open Access Journals |
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