MATERNAL AND FETAL OUTCOME IN RH NEGATIVE PREGNANCY

2021 ◽  
pp. 5-8
Author(s):  
Uma Jain ◽  
Preeti Gupta ◽  
Deepa Gupta ◽  
Deepali Jain
Keyword(s):  
Blood Group ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Postnatal Period ◽  
Serum Bilirubin Level ◽  
Perinatal Morbidity ◽  
Coombs Test ◽  
Maternal Circulation ◽  
Rh Isoimmunization ◽  
Future Pregnancy

INTRODUCTION- When Rh negative maternal blood is exposed to Rh positive fetal blood (RBC) in maternal circulation, antibodies against Rh (D) may develop in the mother. These Rh (D) antibody, once produced, remains in the woman's circulation and poses the threat of hemolytic disease (due to destruction of fetal RBCs ) for subsequent Rh-positive fetuses and this event leads to alloimmunization. Coombs test is the most common method to detect alloimmunization done during pregnancy (ICT) and in postnatal period (DCT). Rhesus (Rh) isoimmunization is an important clinical entity in India and other developing countries, which is responsible for fetal anemia and hydrops fetalis, and if not treated, it can result in intrauterine fetal demise, thus timely diagnosis follow-up and management of Rh –ve pregnancy is must. MATERIAL AND METHODS- st th This is a retrospective observational study, done in a private hospital, Gwalior (M.P.), form 1 Jan. 2018 to 30 June 2020. 88 women with Rh-ve pregnancy were studied during this period, Data was recovered from labor room record, OT, PNC, post operative wards for maternal outcome a SNCU for neonatal outcome. RESULTS- In our study the most common age group was 21-25 years (62.5%), most of the patient were Primigravida(42.4%), most of them were unbooked (65.90%) and from Rural area (72.72%). The most common blood group Rh- was o-ve (53.40%). Only 2 patients had positive indirect coombs test. Most of the patients delivered normally, only (28.40%)Patients delivered by LSCS. Preeclampsia was the most common maternal complication found in Rh- Patient (12.5%). 96.59% of Neonates were live born. 2.27% were fresh still born and 1.13% were macerated still born. 24 babies were admitted in SNCU. The most common cause of admission was neonatal jaundice (66.66%). The most (76.13%) of the babies had serum bilirubin level between 10-15 mg/dl. CONCLUSION- We concluded that Rh isoimmunization leads to increased perinatal morbidity for perinatal morbidity. The obstetrician and maternity staff should be familiar to diagnosis and management of with Rhesus incompatibility and they should counsel the Rh negative patient about Importance of checking blood group and Rh type in pregnancy and should educated them about importance of Rh prophylaxis and Hemolytic diseases of fetus and newborn risks of present and future pregnancy. During past few decades there had been major advances in the medical treatment for Rh negative pregnancy.

STUDIES ON ERYTHROBLASTOSIS DUE TO ABO INCOMPATIBILITY

PEDIATRICS ◽  
1954 ◽  
Vol 13 (6) ◽  
pp. 503-510
Author(s):  
DAVID YI-YUNG HSIA ◽  
SYDNEY S. GELLIS
Keyword(s):  
Blood Group ◽  
Bilirubin Level ◽  
Serum Bilirubin ◽  
Laboratory Data ◽  
Serum Bilirubin Level ◽  
Present Knowledge ◽  
Coombs Test ◽  
Abo Incompatibility ◽  
Rh Incompatibility

Detailed clinical and laboratory data have been presented on 21 infants with erythroblastosis due to ABO incompatibility. A careful survey in one newborn service over a six-month period showed that there were 11 cases of erythroblastosis due to ABO incompatibility as compared to 7 cases of erythroblastosis due to Rh incompatibility, suggesting that the disease occurs with greater frequency than has been hitherto reported. No one test is available which can in every case be absolutely diagnostic of the disease. The criteria useful in suggesting the diagnosis are listed. Practically, the presence of a major blood group incompatibility between infant and mother with a negative Coombs' test, clinical jaundice in the first 24 hours, and a serum bilirubin level of more than 10 mg./100 cc. at 24 hours or less is sufficient to make the diagnosis in the absence of manifest infection. The same criteria for treatment as applied to Rh erythroblastosis should be applied to erythroblastosis due to ABO incompatibility in the light of our present knowledge.

scholarly journals Effect of Rhesus Negative in Pregnancy

2018 ◽  
Vol 30 (1) ◽  
pp. 23-25
Author(s):  
Jamila Khatun ◽  
Ruly Begum
Keyword(s):  
Blood Group ◽  
Perinatal Outcome ◽  
Neonatal Death ◽  
Maternal Blood ◽  
Perinatal Morbidity ◽  
Hemolytic Disease ◽  
Medical College ◽  
Mild Anaemia ◽  
Group B ◽  
Rh Immunization

Hemolytic disease of the newborn due to Rhisoimmunisation is a major cause to perinatal morbidity & mortality. Erythroblastosis fetalis is a disease of fetus and newborn due to incompatibility between fetal and maternal blood group. Diagnosis and therapy for Rh immunization improved considerably. Its prevention by immunoprophylaxis has been responsible for the reduction in the incidence of perinatal mobility. Still Rh immunization and erythroolastosis fetalis is responsible for many obstetric mishaps in our country. To see the pregnancy outcome of Rhesus negative women. This prospective study was carried out from October 2013 to March 2014 in Obstetrics & Gynecology department of Sylhet MAG Osmani Medical College & Hospital, Sylhet. 50 Rh-negative pregnancies were selected those who got admitted in department of Obstetrics & Gynecology, SOMCH. 30.62% of the fetuses had blood group B+ve, 24.40% 0+ve and 20.40% A+ve. Regarding the perinatal outcome 76% were healthy, 4% still birth, 4% neonatal death, 14% with erythroblastosis foetalis and 4% developed hydrops. Mild anaemia and oedema was common in primi and multigravida patients. PET was found 6.2% in multigravida patients. APH and Hydramnios with congenital anomalies were 3.1% and 3.1% respectively. This study was undertaken to evaluate the outcome of pregnancy in Rh -ve women. It is preventable. Primary prevention of isoimmunization by giving combined antenatal and postnatal prophylaxis.Medicine Today 2018 Vol.30(1): 23-25

scholarly journals Maternal and fetal outcome in oligohydramnios after 34 weeks of gestation

2018 ◽  
Vol 7 (11) ◽  
pp. 4604
Author(s):  
Mahantappa A. Chiniwar ◽  
Joe Kaushik M. ◽  
Sharada B. Menasinkai
Keyword(s):  
Amniotic Fluid ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Research Centre ◽  
Control Group ◽  
P Value ◽  
Study Group ◽  
Perinatal Morbidity ◽  
Amniotic Fluid Index ◽  
Chi Square

Background: Oligohydramnios is one of the major causes of maternal and perinatal morbidity and mortality. It is a clinical condition characterized by Amniotic Fluid Index (AFI) ≤5 cm by sonographic assessment. The aim of present study is to know the maternal and fetal outcome in oligohydramnios after 34 weeks of gestation compared with women who had normal volume of amniotic fluid.Methods: Study was done for the period of 21 months from November 2014-July 2016 at Adichunchanagiri Institute of Medical Sciences, Hospital and Research Centre Bellur. 50 antenatal cases with > 34 weeks of gestation with AFI ≤5 cm by ultrasonographic estimation were included as study group and 50 women with normal AFI were included as control group. Maternal and fetal outcome of the women with oligohydramnios were analyzed and compared with control group.Results: Results were analyzed statistically using parameters like mean, SD, Chi Sq test, P value. Amniotic fluid was clear in 32% in study and 78% in control group, thin meconium stained in 30% in study group and 14%in control group and was thick meconium stained in 38% in study group and 8% in control group (Chi square =22.31, p<0.0001). Induction of labour was done in 54% in study group and 20% in control group. Cesarean delivery was done in 58% in study group women and 28% in control group women. Regarding the birth weight of babies 62% were < 2.5 kg in study group and 18% in control group with p<0.001. 10% of babies in study group required NICU admission and perinatal mortality was 2%.Conclusions: Due to increased perinatal morbidity and mortality and increased rate of LSCS, timely decision during labour is important to reduce perinatal morbidity and mortality.

The Maternal Phenylketonuria International Study: 1984–2002

PEDIATRICS ◽  
2003 ◽  
Vol 112 (Supplement_4) ◽  
pp. 1523-1529 ◽  
Author(s):  
Richard Koch ◽  
William Hanley ◽  
Harvey Levy ◽  
Kim Matalon ◽  
Reuben Matalon ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Birth Outcomes ◽  
International Study ◽  
Care Program ◽  
Nonparametric Test ◽  
Maternal Blood ◽  
Fetal Outcome ◽  
Dietary Control ◽  
Maternal Phenylketonuria ◽  
Restricted Diet

Objective. The purpose of this report is to review the obstetric medical, psychological, and nutritional aspects and outcome of the women and offspring enrolled in the Maternal Phenylketonuria Study, which was established to assess the efficacy of a phenylalanine (Phe)-restricted diet in preventing the morbidity associated with this disorder. Methods. A total of 382 women with hyperphenylalaninemia (HPA) were enrolled in the study and completed 572 pregnancies. Outcome measures were analyzed with χ2, Fisher exact text, analysis of variance, t test, Wilcoxon nonparametric test, and multiple logistic regression. Outcome measures were stratified according to maternal HPA classification and the time when dietary control was achieved. Results. Optimal birth outcomes occurred when maternal blood Phe levels between 120 and 360 μmol/L were achieved by 8 to 10 weeks of gestation and maintained throughout pregnancy (trimester averages of 600 μmol/L). Mothers with mild HPA achieved similar birth outcomes as mothers who were in control preconceptually and those in control by 8 to 10 weeks of pregnancy. Conclusions. Before conception, counseling and early entrance into a prenatal care program is essential in achieving optimal fetal outcome in women with HPA. The achievement of pre- and periconceptional dietary control with a Phe-restricted diet significantly decreased morbidity in the offspring of women with HPA.

Oxygen equilibrium properties of blood and hemoglobin of fetal and adult Weddell seals

1981 ◽  
Vol 50 (5) ◽  
pp. 999-1005 ◽  
Author(s):  
J. Qvist ◽  
R. E. Weber ◽  
W. M. Zapol
Keyword(s):  
Whole Blood ◽  
Maternal Blood ◽  
Bohr Effect ◽  
Red Cell ◽  
Fetal Blood ◽  
Maternal Circulation ◽  
Weddell Seals ◽  
Blood Ph ◽  
Ph Decrease ◽  
2,3 Dpg

Oxygen equilibria of whole blood and hemoglobins from adult and fetal Weddell seals are reported. The maternal blood shows a lower O2 affinity than the fetal blood (halfsaturation O2 tension P50 = 26.9 +/- 1.18 and 21.4 +/- 1.25 Torr, respectively, at 37 degrees C and pH 7.4), and a greater Bohr effect (delta log P50/delta pH = -0.49 and -0.31, respectively, at pH 7.4-6.8), correlated with higher red cell 2,3-diphosphoglycerate (2,3-diphosphoglycerate (2,3-DPG) concentrations (6.45 +/- 0.81 mmol.1-1, compared to 2.65 +/- 0-42 mmol.1-1 in the fetus). Both the maternal and fetal erythrocytes contain two major and two minor hemoglobin components occurring in the same ratio and the 2,3-DPG-free whole hemolysates, as well as the isolated major components from each stage, show the same oxygenation properties, ascribing the whole-blood differences to the higher adult DPG levels. A 2,3-DPG effect also appears to account for the disparity in the Bohr effects, which will favor unloading of O2 from the maternal circulation during diving as maternal and fetal blood pH decrease in parallel.

scholarly journals Study of sociodemographic profile, maternal, fetal outcome in preeclamptic and eclamptic women: a prospective study

2019 ◽  
Vol 9 (1) ◽  
pp. 230
Author(s):  
Vedavathi . ◽  
Rajeev Sood
Keyword(s):  
Blood Pressure ◽  
Prospective Study ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Perinatal Outcomes ◽  
Neonatal Morbidity ◽  
Fetal Outcome ◽  
Morbidity And Mortality ◽  
Intrauterine Death ◽  
Perinatal Morbidity

Background: Preeclampsia is pregnancy specific disease, lead to maternal, perinatal morbidity and mortality. This study is conducted to identify the socio demographic profile of subjects suffering from preeclampsia and its effect on maternal and fetal health.Methods: This prospective study was conducted at department of obstetrics and gynecology, Kamla Nehru State Hospital, Shimla, in this, 100 preeclamptic women were included. Preeclampsia was diagnosed with blood pressure of ≥140/90 mmHg noted for the first-time during pregnancy, after 20 wks of gestation and proteinuria. Demographic details were collected. Investigations i.e. hemogram, liver and renal function tests, coagulation profile and fundoscopy were done. Maternal and perinatal outcomes were recorded.Results: In this study, majority of the subjects were primigravida 65. In this, 11 subjects had systolic blood pressure of 140-159 mmHg and 89 subjects had systolic blood pressure of > 160 mmHg. 25 subjects had diastolic blood pressure of 90-109 mmHg and 75 subjects had diastolic blood pressure of > 110 mmHg. In this, 82 subjects had warning symptoms, mainly headache 49. 14 subjects showed hypertensive changes in fundus. Unfavorable Bishop Score, observed in 86 subjects and 78 subjects were induced after controlling blood pressure. Majority of subjects had vaginal delivery 73. Majority of the subjects had deranged liver function 61. Maternal morbidity was reported in 54 subjects. Intrauterine death reported in 14 subjects. Birth weight was < 2.5 kg was observed in 70 babies. Out of 74 live births, 53 neonates required admission in NICU and 16 neonates died in NICU.Conclusions: It may be concluded that, maternal and neonatal morbidity and mortality can be reduced by early identification of risk factors and timely intervention is the hall mark in preventing the maternal and perinatal morbidity and mortality.

scholarly journals Hemolytic Disease of the Newborn Due to Anti-A

Blood ◽  
1953 ◽  
Vol 8 (7) ◽  
pp. 620-639 ◽  
Author(s):  
HAL CRAWFORD ◽  
MARIE CUTBUSH ◽  
P. L. MOLLISON
Keyword(s):  
Blood Group ◽  
Osmotic Fragility ◽  
Red Cells ◽  
Coombs Test ◽  
Hemolytic Disease ◽  
A Cells

Abstract Eleven cases of hemolytic disease of the newborn are described in which the only blood group antibody in the mother's serum, incompatible with the infant's cells, was anti-A. The direct antiglobulin (Coombs) test on the infant's red cells was weakly positive in 7 cases and negative in 4 cases. In every case the mother's serum displayed immune characteristics, in particular the ability to lyse A cells. Osmotic fragility was increased in 10 out of 11 cases. This finding is contrasted with those in a series of cases of hemolytic disease of the newborn due to anti-Rh.

scholarly journals The route of antibodies passing from the maternal to the foetal circulation in rabbits

1949 ◽  
Vol 136 (882) ◽  
pp. 131-144 ◽  
Keyword(s):  
Maternal Blood ◽  
Yolk Sac ◽  
Rabbit Serum ◽  
Maternal Circulation ◽  
Uterine Lumen ◽  
Foetal Circulation ◽  
Circulating Antibodies ◽  
Immune Rabbit ◽  
Foetal Blood

It has long been known that maternal circulating antibodies pass into the foetal blood in rabbits during the latter half of pregnancy. The allanto-chorionic placenta has been assumed to be the site of this transference, the number of tissues separating the two blood streams being reduced to a minimum in rabbits at these stages. It was shown in a recent paper that, at a stage before the establishment of the embryonic circulation, maternal circulating antibodies pass the bilaminar omphalopleur into the yolk-sac cavity. It is shown in this paper that in 24-day embryos antibodies pass from the maternal circulation by way of the uterine lumen and the yolk-sac splanchnopleur into the foetal vitelline circulation, and do not pass by way of the allanto-chorionic placenta. The method employed involved injection of immune rabbit serum either into the uterine lumen or the maternal blood and interruption of the foetal vitelline circulation of some of the embryos by ligaturing the yolk-sac stalk.

Distribution of relaxin between human maternal and fetal circulations and amniotic fluid

1992 ◽  
Vol 134 (2) ◽  
pp. 313-317 ◽  
Author(s):  
M. R. Johnson ◽  
A. Abbas ◽  
K. H. Nicolaides ◽  
S. L. Lightman
Keyword(s):  
Amniotic Fluid ◽  
Placental Transfer ◽  
Geometric Mean ◽  
Maternal Blood ◽  
Fetal Blood ◽  
Maternal Circulation ◽  
Blood Samples

ABSTRACT Relaxin was measured in maternal blood and amniotic fluid samples at 9–40 weeks and in fetal blood samples at 19–41 weeks of pregnancy. In amniotic fluid, concentrations of relaxin rose from 58 ng/1 (geometric mean) at 10 weeks to 142 ng/l at 14 weeks and declined subsequently to 55 ng/l at 22 weeks. In maternal blood, mean relaxin concentrations were ten times greater than in amniotic fluid, and concentrations decreased with gestation. Since there was no significant association between the relaxin concentrations in the two compartments, relaxin in the amniotic fluid may be derived from the decidualized endometrium rather than the maternal circulation, alternatively its metabolism may be different in the two compartments. The absence of detectable concentrations of relaxin in any of the fetal blood samples demonstrates that there is no significant placental transfer or fetal synthesis of this peptide. Journal of Endocrinology (1992) 134, 313–317

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