20 Years of Follow-up Alloimmunization and Hemolytic Disease in Newborn: Has Anything Changed in the Field Over the Years?

2020 ◽  
Vol 232 (06) ◽  
pp. 314-320
Author(s):  
Marjana Jerkovic Raguz ◽  
Zeljka Prce ◽  
Vedran Bjelanovic ◽  
Ivana Bjelanovic ◽  
Sanja Dzida ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Preventive Measures ◽  
Newborn Infants ◽  
Significant Progress ◽  
Hemolytic Disease ◽  
The West ◽  
The Past ◽  
Precautionary Measures ◽  
In Pregnancy

Abstract Objective of the study is to research the epidemiological aspects of maternal alloimmunization against erythrocyte antigens of fetuses (AB0, Rhesus, Lewis, Kell, Duffy and others) and to identify the most common types of hemolytic disease of the newborn (HDN) in the West Herzegovina region. Study Design The 20-year retrospective epidemiological study includes all pregnant women who had been immunologically tested and newborn treated for HDN. Results The indirect antiglobulin (IAT) detected antibodies against antigens in 545 (1.8%) pregnant women of the 29 663 who were tested at the Department of Transfusion Medicine. During the 20-year-long study 310 (1.0%) newborn with HDN were treated. Our results indicate that 42% (230/545) of the pregnant women had AB0 immunization. The most common form of HDN is AB0 HDN 64% (199/310), whereas RhD HDN was treated in 19% (59/310) of the newborn infants. ETR was performed on 29 (19%) infants, 21 (72.4%) with AB0 HDN, and 7 (26%) with RhD HDN. Conclusion This 20-year-long study concludes that, even though there has been significant progress in the prevention of immunization and proactive treatment of HDN, precautionary measures are still required as is the need for gynecologists and obstetricians to be active. The reasons for this are the non-existence of preventive measures for non-RhD immunization, the irregular immunological screening of RhD positive women in pregnancy in the region encompassed by the study in the past few years. The above raises new questions and recommends further research and monitoring of immunization and HDN treatment worldwide.

scholarly journals Izdaja Kell skladnih krvnih komponent z namenom preprečevanja anti-K senzibilizacij pri ženskah v rodni dobi.

2016 ◽  
Vol 85 (4) ◽  
Author(s):  
Andreja Hrašovec-Lampret ◽  
Irena Bricl
Keyword(s):  
Pregnant Woman ◽  
Pregnant Women ◽  
Prenatal Testing ◽  
Perinatal Morbidity ◽  
Hemolytic Disease ◽  
The Past ◽  
Compatible Blood ◽  
Not At Risk ◽  
Transfusion History ◽  
In Pregnancy

 With selecting K compatible blood for transfusion, we prevent K immunization and many unnecessary prenatal testing and gynecological examinations for at least 78% of pregnant women with K negative partners, whose fetus is not at risk of hemolytic disease of fetus and newborn. Abstract  Background Kell antibodies are beside RhD and c antibodies one of most clinically important antibodies that can cause severe hemolytic disease of the fetus and newborn (HDFN) in pregnancy,which is still remaining one of the major causes of perinatal morbidity and mortality. Therefore, pregnant women with eryhrocyte alloantibodies anti-K need many prenatal testing and gynecological examinations. The major cause for anti-K immunisation is transfusion of incompatible blood in the past.    Methods We analysed retrospectively the data of 71 pregnant woman with alloantibodies anti-K, which were followed in Blood Transfusion Centre of Slovenia from 2004 -2014. We collected data of partner´s phenotype and woman´s transfusion history. Data were statistically analyzed with basic statistical methods.   Results 61 out of 71 partners were tested (86%) and 48 were K negative (78%).The transfusion history was available for only 23 women (32%). The transfusion history was available for 23 out of 48 women with K negative partner (48%). All of them were transfused. 78% received incompatible-K positive blood, for the rest 22% women donations they received were not K typed.    Conclusions From the obtained data, we found that in 78% of cases cause for K alloimunnization is transfusion of K incompatible blood in past. With selecting K compatible blood for transfusion, we can prevent K immunization and many unnecessary prenatal testing and gynecological examinations for 78% pregnant women with K negative partners . 

Prevalence and factors associated with anemia in pregnancy among women receiving antenatal care at the West Gonja District Hospital of Northern Ghana.

2020 ◽  
Vol 4 (3) ◽  
pp. 01-12
Author(s):  
Martin Malick
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Hemoglobin Concentration ◽  
World Health ◽  
Multiple Gestation ◽  
The West ◽  
Factors Associated ◽  
Folate Supplement ◽  
Anemia In Pregnancy ◽  
In Pregnancy

Background: Anemia in pregnancy is a major public health problem especially in Low and Middle-income countries (LMIC) including Ghana and is defined by the World Health Organization (WHO) as being present when the hemoglobin concentration in the peripheral blood is 11g/dl or less. In most African countries anemia in pregnancy occurs if the hemoglobin concentration falls below 10g/dl. Pregnant women are at a higher risk of developing anemia due to several factors such as hemodilution, nutritional factors, multiple gestation, socio-economic status and malaria infestation. Anemia in pregnancy is an important cause of maternal mortality and affects half of pregnant women worldwide; with 56% of West African pregnant women being anemic. The objective of this study is to assess the prevalence and identify the risk factors associated with anemia among pregnant women receiving antenatal care at the West Gonja Hospital (WGH) Methods: A cross-sectional was conducted with 136 pregnant women receiving antenatal care at the WGH between January 2017 to February 2018. Random sampling was used to select participants and data was collected using a structured questionnaire. Data was analyzed using the SPSS Version 24.0. Results: A total 71(52.2%) of the study population were anemic, while 65 (47.8%) were not anemic. 20(74.1%) of the 27 pregnant housewives were anemic, while 11(64.7%) of the pregnant farmers were anemic. 27 (96.4%) of the 28 pregnant women who took their iron/folate supplement only some few days were anemic. 12 (100%) of the 12 participants who took their iron/folate supplement a few times a week were anemic. 4 (80%) of the 5 participants who never took their iron/folate supplement were anemic. 21 (70%) of those who did not sleep under ITN were anemic. 33 (84.6%) of the 39 patients who were diagnosed with malaria were also anemic. 28 (87.5%) of the 32 participants who took only 2 meals a day were anemic. 27 (79.4%) of the 34 patients who took liver, beef, chicken and fish only twice weekly were anemic. 15 (88.2%) of the 17 patients who drank tea some days in a week were anemic. Conclusion: Although most of the pregnant women were adequately educated on the most relevant aspects of anemia in pregnancy, more than half of them were still anemic. Anemia was more prevalent among pregnant uneducated housewives with poor nutritional habits. All the pregnant sickle cell disease patients as well as those diagnosed with malaria were also anemic.

scholarly journals Neurosurgical procedures in pregnancy

2003 ◽  
Vol 18 (1) ◽  
pp. 01-13 ◽  
Author(s):  
Bayram Cirak ◽  
Nejmi Kiymaz ◽  
Memduh Kerman ◽  
Kadir Tahta
Keyword(s):  
Surgical Intervention ◽  
Neurosurgical Procedures ◽  
Low Back ◽  
Intracranial Tumors ◽  
The Past ◽  
Neurologic Disorders ◽  
Neurologically Intact ◽  
Neurosurgical Intervention ◽  
In Pregnancy

PURPOSE: Over the past few decades maternal mortality has progressively declined because of improved management of the major obstetric problems of hemorrhage, infection, and toxemia. As a result, the relative incidence of deaths resulting from non obstetric causes has increased. Chief among nonobstetric causes are neurologic disorders. Those most common during pregnancy are low back pain, intracranial tumors, subarachnoid hemorrhage, and neurotrauma. The management of the neurosurgical pathologies during pregnancy needs some specifications for both the mother and the fetus. METHODS: We performed a retrospective study evaluating the clinical, radiological, and surgical characteristics of 9 patients who have cranial neuropathologies and have undergone neurosurgical intervention. RESULTS: Most of the patients in this study had vaginal delivery. Prominent neurosurgical disease related to cerebral damage. Every patient underwent a laboratory and radiological evaluation. All except one survived the neurosurgical pathology. Neither baby nor mother had significant problem during delivery and neurosurgical intervention. CONCLUSION: Pregnant women may face to every kind of neurosurgical pathology that nonpregnant women have faced. In addition, pregnancy itself, gives rise some metabolic changes in the women and those changes may cause some neurologic pathologies to be symptomatic or to aggravate the present symptomatology. Because of those reasons, close neurologic follow up of a pregnant woman is of vital importance. At the end of a pregnancy having experienced some neurologic interventions including diagnostic evaluation or surgical intervention does not necessitates the cesarean section for a neurologically intact infant and mother.

scholarly journals Western Objections to the Islamic Concept of Gender Equality: A Critical Review

Fahm-i-Islam ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. 55-70
Author(s):  
Dr Aurangzeb
Keyword(s):  
Gender Equality ◽  
Critical Review ◽  
Critical Analysis ◽  
View Point ◽  
Significant Progress ◽  
The West ◽  
The Past ◽  
Viable Solution ◽  
The World ◽  
Islamic View

Over the past several years, despite the constant evolution of the legislation the problem of gender equality in the West has been steadily increasing. What is the reason why there is no significant progress in solving gender equality issues in the West yet? Several reports and researches have pointed out to this problem. On the contrary, Islam provides a viable solution to this ever increasing problem; for Islam has a comprehensive yet simple view of gender equality. But the West, instead of understanding Islamic principles objectively, raises objections without a thorough study. However, the Western principle of gender equality has completely failed. In this article a critical analysis of the western gender equality and Islamic principles has been carried out. It also highlights Islamic view point of gender equality. The study argues that the contemporary gender equality problems and issues that have engulfed the world particularly the Western countries can be mitigated by employing the Islamic principles of gender equality

High-Grade Cervical Intraepithelial Neoplasia (CIN) in Pregnancy: Clinicotherapeutic Management

1998 ◽  
Vol 84 (5) ◽  
pp. 567-570 ◽  
Author(s):  
Carlo Penna ◽  
Maria Grazia Fallani ◽  
Maria Maggiorelli ◽  
Elisa Zipoli ◽  
Alessandra Cardelli ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Cervical Intraepithelial Neoplasia ◽  
Young Women ◽  
Intraepithelial Neoplasia ◽  
Histologic Examination ◽  
First Year ◽  
High Grade ◽  
In Pregnancy

An increasing incidence of cervical intraepithelial neoplasia (CIN) among young women has been noticed in recent years. For this reason pregnancy might represent a peculiar opportunity to undergo cytocolposcopic examination for those women who do not take part in a screening program for cervical carcinoma. Diagnosis of CIN during pregnancy poses the question of the management of this disease and particularly of whether it is better to treat the lesion or not during pregnancy. To contribute to the solution of this issue we initiated a study on the management of high-grade CIN in pregnancy. Material and methods Five hundred and seventy-one pregnant women underwent cytologic, colposcopic and, when necessary, histologic examination. Those in whom a CIN was discovered in the first four months of gestation underwent laser conization. When the diagnosis of CIN was made after the sixteenth week of gestation, cytocolposcopic monitoring was performed every eighth week during pregnancy and two months after childbirth. Laser conization was performed under colposcopic guidance in the outpatient setting in all cases. All treated patients were submitted to cytologic, colposcopic and, if necessary, histologic examination every third month in the first year after treatment, every sixth month in the second year and yearly from the third year onwards. Results In 14 (2.4%) of the 571 examined women a CIN III was discovered, 6 of which associated with a human papilloma virus (HPV) infection. Of these, 8 patients, whose diagnosis was made within the sixteenth week of pregnancy, underwent laser conization. In one case a minor hemorrhage occurred during treatment. Two patients reported minor bleeding up to ten days after treatment. No major hemorrhages or cervical stenosis were observed. Histologic examination of the cones confirmed the preoperative diagnosis based on cervical biopsies and the lesion was entirely removed by conization in all cases. Seven of the 8 patients who underwent laser conization during pregnancy had a spontaneous delivery at term. The remaining patient, who had had a previous cesarean section, was again delivered by cesarean section. All treated patients were cured after the first-year follow-up visit. In 6 patients CIN was diagnosed after the sixteenth week of pregnancy. These women underwent cytocolposcopic examination every eighth week during pregnancy and two months after delivery, when the cervical changes associated with gestation had disappeared. Four of these patients showed persistence of CIN at postpartum follow-up and therefore underwent laser conization. In two patients spontaneous regression of the lesion was observed. In no case did progression to invasive carcinoma occur. Conclusions Given the increasing incidence of CIN in young women, the beginning of pregnancy may represent a peculiar opportunity for all pregnant women who do not take part in cervical screening programs to undergo a cytocolposcopic examination. In case of a diagnosis of high-grade CIN within the first 16 weeks of pregnancy, a conservative excisional treatment, which does not expose the pregnancy to any risk, should be carried out in order to confirm the intraepithelial localization of the lesion.

Is the MMR vaccination programme failing to protect women against rubella infection?

2013 ◽  
Vol 142 (5) ◽  
pp. 1114-1117 ◽  
Author(s):  
S. SKIDMORE ◽  
E. BOXALL ◽  
S. LORD
Keyword(s):  
Pregnant Women ◽  
Vaccination Programme ◽  
The West ◽  
Repeat Testing ◽  
Rubella Infection ◽  
West Midlands ◽  
Second Year ◽  
In Pregnancy

SUMMARYIn recent years the number of pregnant women susceptible to rubella has increased markedly. In the West Midlands the proportion has risen from 1·4% in 2004 to 6·9% in 2011. Locally, the proportion of non-immune women ranges from 1·6% in those born prior to 1976 to 17·8% in those born since 1986. The latter group comprises those given MMR in their second year with no further booster doses. The number of non-immune women will continue to rise as a consequence of low MMR uptake in the late 1990s. Repeat testing of samples with values <10 IU/ml and the need to vaccinate women postnatally have increased the workload of laboratory and maternity units. Screening for rubella in pregnancy has no advantages for the current pregnancy and it may be time to review the universal MMR vaccination programme which in turn would remove the need for continuing this practice.

Swimming and diving by pregnant women

1996 ◽  
Vol 8 (3) ◽  
pp. 165-171 ◽  
Author(s):  
Frederik K Lotgering ◽  
Wilhelmina EM Spinnewijn ◽  
Henk CS Wallenburg
Keyword(s):  
Pregnant Women ◽  
Strenuous Exercise ◽  
Physically Active ◽  
Poor Condition ◽  
The Past ◽  
In Pregnancy ◽  
Do So

Pregnant women have traditionally been discouraged from participating in physically demanding sports because they have been considered to be in poor condition and it was thought that strenuous exercise could harm the mother and the fetus. More recently, however, many physically active women have wished to continue sport in pregnancy and research over the past 20 years has shown that in general it is safe to do so.

Urinary Estrogens in Pregnancy

1956 ◽  
Vol 2 (3) ◽  
pp. 184-187 ◽  
Author(s):  
Rudolph M Anker
Keyword(s):  
Pregnant Women ◽  
New Method ◽  
The Past ◽  
Steroid Conjugates ◽  
Urinary Estrogens ◽  
In Pregnancy

Abstract A new method has been described for the cleavage of the estrogenic steroid conjugates occurring in the urine of pregnant women. It yields higher estrogen values than the methods which have been employed in the past.

scholarly journals Conhecimento de Gestantes Sobre a Síndrome Hipertensiva Gestacional

2018 ◽  
Vol 86 (24) ◽  
Author(s):  
Lia Maristela da Silva Jacob ◽  
Daniela Gardano Bucharles Mont’Alverne ◽  
Maura Cristiane e Silva Figueira ◽  
Reginaldo Roque Mafetoni ◽  
Cláudia Jeane Lopes Pimenta ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Promotion ◽  
High Pressure ◽  
Focus Group ◽  
Prenatal Care ◽  
Pregnant Women ◽  
Cultural Context ◽  
Primary Care Professionals ◽  
In Pregnancy

Este estudo objetiva analisar os saberes de gestantes sobre a síndrome hipertensiva da gestação para criar e validaruma cartilha sobre o tema de acordo com o contexto vivenciado. Trata-se de um estudo descritivo-exploratório,qualitativo, utilizando grupos focais com gestantes assistidas no pré-natal em Fortaleza, Ceará, Brasil. Participaram oitogestantes em acompanhamento do pré-natal de baixo risco. Durante o grupo focal emergiram duas categorias: (Des)saberes sobre a pressão alta na gravidez e Dificuldades no tratamento/acompanhamento. Os resultados apontaramsaberes insuficientes, ocasionando dúvidas sobre as causas, evolução e tratamento das síndromes hipertensivas.Percebe-se a necessidade dos profissionais da atenção básica adequarem estratégias de assistência mais voltadas aossaberes e ao contexto socioeconômico e cultural das gestantes realizando ações educativas que sejam compreendidase possíveis de implementação.Palavras-chave: Gestantes; Hipertensão Induzida pela Gravidez; Promoção à Saúde; Educação em Saúde. AbstractThis study aims to analyze the knowledge of pregnant women about gestational hypertensive syndrome to create andvalidate a booklet about the theme according to the experienced context. This is a descriptive-exploratory, qualitativestudy using focal groups with pregnant women assisted in prenatal care in Fortaleza, Ceará, Brazil. Participants wereeight pregnant women attending low-risk prenatal care. During the focus group two categories emerged: (Des)knowledge about high pressure in pregnancy and Difficulties in treatment/follow-up. The results indicated insufficientknowledge, causing doubts about the causes, evolution and treatment of hypertensive syndromes. It is noticed theneed of the primary care professionals to adapt assistance strategies more focused on the knowledge and thesocioeconomic and cultural context of the pregnant women, carrying out educational actions that are understood andpossible to implement.Keywords: Pregnant Women; Hypertension, Pregnancy-Induced; Health Promotion; Health Education.

Narcotic Withdrawal Syndrome in the Newborn

1982 ◽  
Vol 3 (9) ◽  
pp. 285-291
Author(s):  
Avron V. Sweet
Keyword(s):  
United States ◽  
Pregnant Women ◽  
Methadone Maintenance ◽  
Newborn Infants ◽  
The United States ◽  
Opiate Addiction ◽  
Major Health ◽  
Homogeneous Groups ◽  
Narcotic Addiction ◽  
In Pregnancy

The passive addiction of fetuses to narcotics has been a matter of record for nearly a hundred years. But even as late as the first half of this century, few physicians were aware of the manifestations of withdrawal by the newborn or its therapy. From the late 1950s, when narcotic addiction increased to become a widespread major health calamity, to the present a great deal has been learned about addiction among pregnant women and its effects upon the fetus and newborn. For two decades addiction was most commonly due to heroin but, following the widespread establishment of methadone maintenance clinics, that synthetic opioid now may be the most frequently encountered addictive agent among pregnant women and their newborn infants in the United States. Some appears as unprescribed "street" methadone, which is usually used with an opiate. Moreover, uncooperative participants in methadone maintenance programs also take opiates. As a consequence, there may be homogeneous groups of pregnant heroin addicts and hornogenous groups of pregnant women taking methadone alone but there is a great deal of drug heterogeneity among addicts. Hence, much is known about opiate addiction in pregnancy and its effects upon the fetus and newborn, but much less is certain about the effects of methadone alone.

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