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Similar Publications

Serial intrauterine transfusion for severe fetal anemia due to anti-M alloimmunization.

Asian J Transfus Sci

September 2022

Department of Obstetrics and Gynecology, Faculty of Medicine Padjajaran University, Hasan Sadikin General Hospital, Bandung, Indonesia.

Anti-M antibody is one of the causes of severe fetal anemia and intrauterine death despite its relatively low frequency. A G3P2 26-year-old pregnant woman referred to our hospital at 29 weeks gestational age (WGA) with fetal hydrops. Her second pregnancy results in intrauterine fetal death at 35 WGA due to fetal hydrops.

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Background: Although ABO and RhD are the clinically significant blood group antigens that are routinely tested for, other blood group antigens may become important in multiply transfused patients due to risk of alloimmunization. Knowledge of antigen prevalence in a population is important in the context of alloimmunization and antigen matching. This study aims to do the same in a population of voluntary blood donors of a center in South India.

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Hemolytic disease of foetus and newborn (HDFN) is a disease characterized by the destruction of fetal red cells by the maternal antibodies which occurs due to allo immunization in the mother by feto-maternal blood group incompatibility. The antibodies most frequently implicated in HDFN may vary depending on the demographic location under consideration. In areas where RhIg administration is available, ABO antibodies are more commonly implicated.

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The traditional approach to resuscitating injured women of childbearing potential (WCBP) with an unknown RhD type is to transfuse RhD-negative blood products. This is to prevent alloimmunisation to the RhD antigen and ultimately prevent haemolytic disease of the fetus and newborn (HDFN) in future pregnancies should she survive. RhD-negative blood products are scarce in both military and civilian blood stocks.

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Alloimmunization during pregnancy occurs when a mother produces antibodies against fetal antigens, leading to complications like hemolytic disease of the fetus and newborn (HDFN) and fetal and neonatal alloimmune thrombocytopenia (FNAIT). HDFN involves destruction of fetal red blood cells, potentially causing severe anemia, hydrops fetalis, and fetal death. FNAIT affects fetal platelets and possibly endothelial cells, resulting in risk of intracranial hemorrhage and brain damage.

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