Abstract:
BACKGROUND:The aims of this study were to determine the prevalence of the different anti-erythrocytic alloantibodies, to describe pregnancy outcomes according to a low-risk and high-risk classification for fetal anemia and to determine the factors that influence adverse perinatal outcomes. METHODS:This retrospective observational study included women referred to our center following the identification of maternal anti-erythrocytic alloantibodies between 2002 and 2017. Pregnancies were classified as high risk for fetal anemia in cases with clinically significant antibodies, no fetal-maternal compatibility and titers ≥1:16 or any titration in cases of Kell system incompatibility. In high-risk pregnancies, maternal antibody titration and the fetal middle cerebral artery peak systolic velocity (MCA-PSV) were monitored. Low-risk pregnancies underwent routine pregnancy follow-up. RESULTS:Maternal antibodies were found in 337 pregnancies, and 259 (76.9%) of these antibodies were clinically significant. The most frequent antibodies were anti-D (53%) and anti-K (19%). One hundred forty-three pregnancies were classified as low risk for fetal anemia, 65 (25%) cases were classified as no fetal-maternal incompatibility, 78 had clinically nonsignificant antibodies, 4 (2.8%) resulted in first-trimester pregnancy loss, and 139 (97.2%) resulted in livebirths. Of the 194 high-risk pregnancies, 38 had titers < 1:16 (resulting in 38 livebirths), and 156 had titers ≥1:16 or anti-K antibodies. In the last group, 6 cases miscarried before 18 weeks, 93 had a MCA-PSV < 1.5 multiples of the median (MoM), resulting in 3 perinatal deaths that were unrelated to fetal anemia, one termination and 89 livebirths; and 57 had a MCA-PSV > 1.5 MoM, resulting in 3 intrauterine deaths, 6 terminations and 48 livebirths. Ninety-two intrauterine transfusions were performed in 45 fetuses (87% anti-D). Adverse outcomes were related to a MCA-PSV > 1.5 MoM (p < 0.001), hydrops (p < 0.001) and early gestational age at first transfusion (p = 0.029) CONCLUSION: Anti-D remains the most common antibody in fetuses requiring intrauterine transfusion. A low or high-risk classification for fetal anemia based on the type of antibody, paternal phenotype and fetal antigen allows follow-up of the pregnancy accordingly, with good perinatal outcomes in the low-risk group. In the high-risk group, adverse perinatal outcomes are related to high MCA-PSV, hydrops and early gestational age at first transfusion.
journal_name
BMC Pregnancy Childbirthjournal_title
BMC pregnancy and childbirthauthors
Sánchez-Durán MÁ,Higueras MT,Halajdian-Madrid C,Avilés García M,Bernabeu-García A,Maiz N,Nogués N,Carreras Edoi
10.1186/s12884-019-2525-ysubject
Has Abstractpub_date
2019-10-15 00:00:00pages
356issue
1issn
1471-2393pii
10.1186/s12884-019-2525-yjournal_volume
19pub_type
杂志文章abstract:BACKGROUND:Pregnancy is a period of transition with important physical and emotional changes. Even in uncomplicated pregnancies, these changes can affect the quality of life (QOL) of pregnant women, affecting both maternal and infant health. The objectives of this study were to describe the quality of life during uncom...
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
doi:10.1186/1471-2393-9-38
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/1471-2393-14-236
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abstract:BACKGROUND:Pregnant women sometimes worry about their unborn baby's health, often due to decreased fetal movements. The aim of this study was to examine how women, who consulted health care due to decreased fetal movements, describe how the baby had moved less or differently. METHODS:Women were recruited from all seve...
journal_title:BMC pregnancy and childbirth
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doi:10.1186/s12884-016-0922-z
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journal_title:BMC pregnancy and childbirth
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doi:10.1186/1471-2393-8-5
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:BMC pregnancy and childbirth
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:BMC pregnancy and childbirth
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,评审
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,随机对照试验
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章
doi:10.1186/1471-2393-11-40
更新日期:2011-06-01 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12884-019-2553-7
更新日期:2019-11-11 00:00:00
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journal_title:BMC pregnancy and childbirth
pub_type: 杂志文章,meta分析
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更新日期:2019-12-30 00:00:00