scholarly journals Laboratory Monitoring of Mother, Fetus, and Newborn in Hemolytic Disease of Fetus and Newborn

2021 ◽  
pp. 1-10
Author(s):  
Morten Hanefeld Dziegiel ◽  
Grethe Risum Krog ◽  
Anne Todsen Hansen ◽  
Marianne Olsen ◽  
Birgitte Lausen ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Peak Systolic Velocity ◽  
Screen Test ◽  
Current Approach ◽  
University Hospital ◽  
Laboratory Monitoring ◽  
Velocity Measurements ◽  
Hemolytic Disease ◽  
Non Invasive ◽  
Intrauterine Transfusion

<b><i>Background:</i></b> Laboratory monitoring of mother, fetus, and newborn in hemolytic disease of fetus and newborn (HDFN) aims to guide clinicians and the immunized women to focus on the most serious problems of alloimmunization and thus minimize the consequences of HDFN in general and of anti-D in particular. Here, we present the current approach of laboratory screening and testing for prevention and monitoring of HDFN at the Copenhagen University Hospital in Denmark. <b><i>Summary:</i></b> All pregnant women are typed and screened in the 1st trimester. This serves to identify the RhD-negative pregnant women who at gestational age (GA) of 25 weeks are offered a second screen test and a non-invasive fetal RhD prediction. At GA 29 weeks, and again after delivery, non-immunized RhD-negative women carrying an RhD-positive fetus are offered Rh immunoglobulin. If the 1st trimester screen reveals an alloantibody, antenatal investigation is initiated. This also includes RhD-positive women with alloantibodies. Specificity and titer are determined, the fetal phenotype is predicted by non-invasive genotyping based on cell-free DNA (RhD, K, Rhc, RhC, RhE, ABO), and serial monitoring of titer commences. Based on titers and specificity, monitoring with serial peak systolic velocity measurements in the fetal middle cerebral artery to detect anemia will take place. Intrauterine transfusion is given when fetal anemia is suspected. Monitoring of the newborn by titer and survival of fetal red blood cells by flow cytometry will help predict the length of the recovery of the newborn.

scholarly journals The Significance of Imunohematology Research in Relation to Menagement of Hemolitical Diseases of the Newborn in Republic of Macedonia

2014 ◽  
Vol 2 (3) ◽  
pp. 456-560 ◽  
Author(s):  
Emilija Velkova
Keyword(s):  
Pregnant Women ◽  
Clinical Significance ◽  
Morbidity And Mortality ◽  
Moderate Degree ◽  
Hemolytic Disease ◽  
Successful Management ◽  
Republic Of Macedonia ◽  
Intrauterine Transfusion ◽  
Screening And Identification

AIM: Prompt discovery of allosensibilisation to RBC’s antigens during pregnancy and successful management of HDFN in Republic of Macedonia, in order to decrease morbidity and mortality of the fetus and the newborn.MATERIALS AND METHODS: The study comprises in total 23,800 patients, 14,858 pregnant women and 8,842 newborn babies.RESULTS: The screening and identification of anti RBC’s antibodies detected in total 216 alloantibodies, out of which 81% (175) had a clinical significance. Out of the above mentioned 164 alloantibodies (65.9%) belong to the Rh system. The most often reason for a severe hemolytic disease is the anti-D antibody. The HDFN symptoms of mild and moderate degree demonstrated 32.5%, and 18.9% had symptoms of severe fetal suffering, and almost half of them (48%) were with or with mild HDFN and had no need of therapy. In 15% it was about alloantibodies of other Rg antigens: anti-C, anti-E and anti-c, at which in most cases there were no signs of HDFN, or it showed weak symptoms (89%), just one case of anti-c ended with intrauterine death.CONCLUSIONS: Anti D antibody represents the most often reason for severe HDFN and displays a need of intrauterine transfusion and exsangvino transfusion. Anti-c is the only antibody that demonstrated the same potential for severe HBN as the anti-D. The most often reason for alloimmunisation of the mother is the lack of RhIG prophylaxis (97.8): postnatal, antenatal and in case of possible sensible conditions during pregnancy. Thus, there is a need and an outmost importance of elaboration and adoption of the National programe for RhIG prophylaxis in Republic of Macedonia.

scholarly journals Hemolytic disease of the fetus and newborn: managing the mother, fetus, and newborn

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 146-151 ◽  
Author(s):  
Meghan Delaney ◽  
Dana C. Matthews
Keyword(s):  
Heart Failure ◽  
Pregnant Women ◽  
Blood Group ◽  
Acute Phase ◽  
Maternal Blood ◽  
Fetal Anemia ◽  
Red Cell ◽  
Hemolytic Disease ◽  
Cell Destruction ◽  
Intrauterine Transfusion

AbstractHemolytic disease of the fetus and newborn (HDFN) affects 3/100 000 to 80/100 000 patients per year. It is due to maternal blood group antibodies that cause fetal red cell destruction and in some cases, marrow suppression. This process leads to fetal anemia, and in severe cases can progress to edema, ascites, heart failure, and death. Infants affected with HDFN can have hyperbilirubinemia in the acute phase and hyporegenerative anemia for weeks to months after birth. The diagnosis and management of pregnant women with HDFN is based on laboratory and radiographic monitoring. Fetuses with marked anemia may require intervention with intrauterine transfusion. HDFN due to RhD can be prevented by RhIg administration. Prevention for other causal blood group specificities is less studied.

Modern methods of treatment of intrauterinenon-immune fetal hydropsinduced by parvovirus infection

2020 ◽  
pp. 43-47
Author(s):  
N.P. Bondarenko ◽  
◽  
V.P. Lakatosh ◽  
Ya.M. Vitovsky ◽  
T.T. Narytnyk ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Parvovirus B19 ◽  
Peak Systolic Velocity ◽  
Terminal Condition ◽  
Fetal Anemia ◽  
Second Trimester ◽  
Gestation Age ◽  
Intrauterine Transfusion ◽  
Lethal Rate

During ultrasonography examinationfetuses infected by parvovirus B19, we have established 36/129 (27.9%) cases of non-immune hydrops in the different periods of pregnancy.The hyperdynamic type of blood flow in fetal middle cerebral arterial was observed in fetuses at the second trimester. Measurement of fetal middle cerebral arteria peak systolic velocity was started at 18 weeks of gestationonce a week in pregnant women who were infected by parvovirus B19. During our study were found 17 cases of severe fetal anemia which manifested after 18 weeks of gestation.Intrauterine transfusions were performed for 11 pregnant women with parvovirus induced fetal hydrops whose gestation age were between 22.4 -25.7 (average 24.0±0.2). After cordocentesis11 cases of severe fetal anemia were confirmed.In the last 6 cases fetuses were diagnosed terminal condition due to women`s refusal of intrauterine transfusion or untimely admission to the hospital. Taking to account the results of study, the efficacy of treatment non-immune hydrops infected by parvovirus B19 with severe fetal anemia and outcomes were evaluated and analyzed. Successful treatment of parvovirus-induced fetal non-immune hydrops in the second trimester of pregnancy has been found in 72.7% cases (OR=95%) after intrauterine transfusion compared to 100% lethal rate in fetuses with non-immune hydrops and severe anemia who were not treated. Criteria for effectiveness of intrauterine transfusion are in time diagnosis of severe fetal anemia in infected fetus with non-immune hydrops, determine the optimal gestation age for intrauterine transfusion, indicators of viremia in umbilical cord blood, the compensatory capacity of the fetus based on Doppler metric indicator of middle cerebral arterial peak systolic velocity and changes blood flow in ductus venous of the fetus. It helps to reduce perinatal loss. Keywords: parvovirus infection, non-immune hydrops fetalis, intrauterine transfusion.

scholarly journals The effects of acupressure on labor pains during child birth: randomized clinical trial

2016 ◽  
Vol 24 (0) ◽  
Author(s):  
Reginaldo Roque Mafetoni ◽  
Antonieta Keiko Kakuda Shimo
Keyword(s):  
Clinical Trial ◽  
Pregnant Women ◽  
University Hospital ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
P Value ◽  
Non Invasive ◽  
And Control ◽  
To Receive

ABSTRACT Objective: to analyze the effects of acupressure on the sanyinjiao point for pregnant women in labor at public maternity wards. Method: single-blind controlled clinical trial, randomly done employing a pragmatic profile. We selected 156 pregnant women in their ≥ 37 week/s, who had cervical dilations of ≥ 4 cm and with two or more contractions in 10 minutes. The pregnant women were randomly divided into three groups at a university hospital in the suburbs of Sao Paulo, Brazil, in order to receive either acupressure treatment, a placebo or participate as part of a control group. The acupressure was applied on the sanyinjiao point during the contractions for 20 minutes. Then the intensity of the pain was evaluated using the Visual Analogue Scale (VAS). Results: The averages for the pain measured using the VAS were not different for the three groups that were a part of the study (p-value=0.0929), however they were less in the acupressure groups immediately after receiving the treatment (p-value=<0.0001). This was also the case where the treatment lasted for 1 hour (p-value=0.0001). This was the case in comparison with placebo and control groups. Conclusion: the use of acupressure on the sanyinjiao point is a useful way to alleviate pain in a non-invasive manner. It can improve the quality of care given to pregnant women in labor. Register: RBR-9mhs8r.

CURRENT APPROACH ON CUTANEOUS MELANOMA DIAGNOSTICS

2019 ◽  
Vol 65 (5) ◽  
pp. 638-644
Author(s):  
Mariya Ebert ◽  
Georgiy Gafton ◽  
Grigoriy Zinovev ◽  
I. Gafton
Keyword(s):  
Physical Examination ◽  
Cutaneous Melanoma ◽  
Growth Dynamics ◽  
Current Approach ◽  
Clinical Diagnostics ◽  
Skin Tumors ◽  
Steady Increase ◽  
Non Invasive ◽  
Early Stages ◽  
Other Information

Melanoma is on the first place in mortality among all skin tumors. Over the past 50 years, there has been a steady increase in the incidence of cutaneous melanoma compared to other types of tumors. Rates of 5-year survival are fairly high, if melanoma is diagnosed in the early stages, which requires adequate diagnostics and treatment. Melanoma diagnostic, especially in the early stages, can be problematic even for an experienced dermatologist. However, primary contact doctor can be any specialty. Melanoma and other skin tumors can be detected by physical examination during treatment for another disease. Phenotypic risks factors, anamnestic data, and physical examination data are important in cutaneous melanoma diagnostics. The sensitivity of clinical diagnosis during a visual examination by an experienced dermatologist is approximately 70 percent. However, dermascopy can significantly increase the accuracy of a clinical diagnostics. In recent years there has been an active research for new non-invasive methods and algorithms for cutaneous melanoma diagnostics. The main goal of non-invasive diagnostics is to determine need for biopsy. This decision should be based on a combination of clinical and dermascopic examinations and other information, including growth dynamics, symptoms and medical history. Thus, an adequate diagnostic of cutaneous melanoma, including non-invasive and invasive methods, is a simple and economically viable way to early detection of cutaneous melanoma and to reduce mortality from this aggressive disease.

Risk Factors and Outcome of Pretrem Labor in Pregnant Women Attending Zagazig Maternity University Hospital

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Hassan Hassan Nassar ◽  
Ali Ali ◽  
Sherin Shazly ◽  
Ahmed Mansour
Keyword(s):  
Risk Factors ◽  
Pregnant Women ◽  
University Hospital

scholarly journals Health-related quality of life in different trimesters during pregnancy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Huailiang Wu ◽  
Weiwei Sun ◽  
Hanqing Chen ◽  
Yanxin Wu ◽  
Wenjing Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

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