Management of pregnancies complicated by anti-c isoimmunization.

Abstract:

OBJECTIVE:To review cases of anti-c isoimmunization and determine the most appropriate management strategies. METHODS:We performed a review of 102 pregnancies managed at The Ohio State University from 1967 to 2001 for anti-c isoimmunization. Of these, 55 had complete data and are included in this report. Information collected included serum titers, deltaOD450 values, Liley zones, fetal and neonatal hemoglobin levels and antigen typing, neonatal direct antiglobulin test, and neonatal outcomes. The appropriateness of traditional management was then evaluated. RESULTS:Of the 55 pregnancies, 46 had fetuses with positive direct antiglobulin test, and nine pregnancies had unaffected fetuses. Of the affected neonates, 12 (26%) had serious hemolytic disease of the newborn. Of these 12, 8 required fetal transfusion, and the remaining 4 newborns had hemoglobin levels of less than 10 g/dL at the time of delivery. A titer of 1:32 or greater or the presence of hydrops fetalis identified all such fetuses. There were 58 amniocenteses performed for deltaOD450 When plotted on modified Liley graphs, deltaOD450 values corresponded to disease severity. There were no perinatal deaths attributable to anti-c hemolytic disease of the newborn. CONCLUSION:Anti-c isoimmunization might cause significant fetal and newborn hemolytic disease. A titer of 1:32 or greater or evidence of hydrops fetalis identified all the serious hemolytic disease at our institution. The significance of antibody titers and deltaOD450 values was similar to Rh-D sensitized pregnancies, and management by the same modalities is appropriate.

journal_name

Obstet Gynecol

authors

Hackney DN,Knudtson EJ,Rossi KQ,Krugh D,O'Shaughnessy RW

doi

10.1097/01.AOG.0000109206.22354.2C

subject

Has Abstract

pub_date

2004-01-01 00:00:00

pages

24-30

issue

1

eissn

0029-7844

issn

1873-233X

pii

103/1/24

journal_volume

103

pub_type

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