Clinical and Immunohaematological Course of 64 Cases Of Antenatal Rh D Alloimmunisation At A Tertiary Care Centre In India
Clinical And Immunohaematological Course
DOI:
https://doi.org/10.70284/njirm.v5i5.800Keywords:
clinical course, Rh D alloimmunisation, antenatal women,hemolytic diseaseAbstract
Background and Objectives: Incidence and outcome of Hemolytic disease of Fetus and New-born due to RhD alloimmunisation has changed in last few decades after the advent of RhIG and other diagnostic and therapeutic tools. But reports from different centres vary. In this study Rh D sensitised antenatal women were followed up at Medical college, Trivandrum and clinical &laboratory profile analysed. Objectives of the study are to describe the clinical &laboratory profile of Rh D alloimmunised pregnant ladies and to describe severity and treatment of Hemolytic Disease in their off springs. Materials and Methods: Cross sectional study done on 64 antenatal cases, positive for anti Rh D antibodies by ICT and followed up with serial titres and ultrasound. Cord blood values and Direct Coombs test were used to diagnose HDFN at birth. Data was analyzed in SPSS ver.17.catagorical data was expressed in percentages and continuous data was expressed with mean and standard deviation. Results: Out of 2,496 Rh D negative women tested with ICT, 78 (3.12%) were positive.54 RhD positive new-borns were DCT positive (93.1%).50.9% cases were unaffected or mild. Severe cases accounted for 10% only. Majority (50%) received no treatment and phototherapy was the major modality of treatment. Overall survival rate of affected new-borns was 92.18%. Out of 6 hydropic babies, 4 died in utero. Interpretations and Conclusions: Rh alloimmunisation is still prevalent among antenatal women, but majority of cases produces only mild disease in new-born. Survival rate in newborns is >90%. Hydropic babies have a higher death rate. Better strategies to prevent Rh D alloimmunization and introduction of interventions like IUT are warranted. [Shaiji PS NJIRM 2014; 5(5):38-43]
References
2. Bowman JM. Hemolytic disease (erythroblastosis fetalis). In: Creasy RK, Resnik R. Maternal-fetal medicine. 4th edition. Philadelphia: WB Saunders; 1999:736-767
3. Wintrobe's Clinical Hematology, 11th ed. Lippincott, Williams, and Wilkins, Philadelphia, 207.
4. Belinga Suzanne, Ngo Sack Françoise. High Prevalence of Anti-D Antibodies Among Women of Childbearing Age at Centre Pasteur of Cameroon .Afr J Reprod Health 2009; 13[3]:47-52..
5. Rao, R. R., Gupte, S. C., Dastur, N. A., Walvekar, V. R. and Pandit, R. D. (1986), A Review of 58 Rh-Isoimmunised Cases. Asia-Oceania Journal of Obstetrics and Gynaecology, 12: 207–211.
04.p 2389-93
6. Dadhwal V, Deka D,Gurunath S, Treatment of Fetal Anemia in Rh Isoimmunized pregnancies With Intrauterine Fetal Blood Transfusion, J Obstet Gynecol India Vol. 60, No. 2 : 2010 pg 135-140
7. Trainor B, Tubman R. The emerging pattern of hydrops fetalis: incidence, aetiology and management. Ulster Med J. 2006;75:185-186
8. Renkonen KO, Seppälä M :The sex of the sensitizing Rh-positive child. Ann Med Exp Fenn 1962 40: 108
9. Renkonen KO, Timonen S Factors influencing the immunization of Rh-negative mothers J Med Gen 1967;.4:166
10. Craig S, Morris K, Tubman T, McClure B. The fetal and neonatal outcomes of Rhesus D antibody affected pregnancies in Northern Ireland Ir Med J. 2000 Jan-Feb;93(1):17-8.
11. Filbey D, Berseus O, Sandström B, Wesström G. The evaluation of maternal anti-D concentrations during pregnancy. Early Hum Dev. 1987 Jan;15(1):1-9
12. Bowell PJ, Wainscot JS, Peto TEA et al. Maternal anti-D concentrations and outcome in rhesushaemolytic disease of the newborn. BMJ 1982;285: 327–329
13. Z. Shamir and J. Gurevitch.38 cases of haemolytic Disease of the Newborn Arch Dis Child 1953 28: 292-296
