Relationship between obstetric history and rh(d) alloimmunization severity

dc.creatorLobato, Gustavo
dc.creatorSoncini, Cristina Silveira
dc.date2015-07-06T11:55:38Z
dc.date2015-07-06T11:55:38Z
dc.date2008
dc.date.accessioned2023-09-26T21:06:47Z
dc.date.available2023-09-26T21:06:47Z
dc.identifierLOBATO, Gustavo; SONCINI, Cristina Silveira. Relationship between obstetric history and rh(d) alloimmunization severity. Archives of Gynecology and Obstetrics, Munchen, v. 277, p. 245–248, 2008.
dc.identifier1432-0711
dc.identifierhttps://www.arca.fiocruz.br/handle/icict/11088
dc.identifier10.1007/s00404-007-0446-x
dc.identifier.urihttps://repositorioslatinoamericanos.uchile.cl/handle/2250/8869350
dc.descriptionBackground To evaluate the relationship between obstetric history and Rh(D) alloimmunization severity, employing the gestational age at the Wrst intrauterine fetal transfusion (IUT) as an indicator of this severity. Methods From 1996 to 2006, Rh(D) alloimmunized pregnancies submitted to IUT had their data assessed. Gestational age at the Wrst IUT was modeled as a linear outcome. The associations between obstetric history variables, anti- Rh(D) antibodies titer and gestational age at the Wrst IUT were analyzed. Statistics are presented with 95% conWdence intervals (P < 0.05). Results A total of 82 non-hydropic anemic fetuses, ensuing in 92.7% (n = 76) of perinatal survival, were submitted to IUT. Nineteen (23,2%) pregnant women did not present with any previous stillbirth, neonatal death, IUT, hydrops or neonatal exchange transfusion (group 1); and 63 (76.8%) reported at least one of these events (group 2). Gestational age at the Wrst IUT diVered signiWcantly between the groups (P = 0.0001). For group 1, it ranged from 24 to 35 weeks (median 32.5 weeks), whereas for group 2 it ranged from 19 to 34 weeks (median 27 weeks). In the multivariated analysis, previous neonatal death (P = 0.040), previous IUT (P = 0.000) and previous neonatal exchange transfusion (P = 0.036) were independently associated with the gestational age at the Wrst IUT. Conclusions The evaluation of the obstetrical history is an important diagnostic tool for predicting Rh(D) alloimmunization severity. Alloimmunized pregnant women who reported previous neonatal death(s), neonatal exchange transfusion(s) or IUT(s) should receive a closer fetal surveillance due to the risk of a higher rate of fetal hemolysis and the need of an earlier IUT.
dc.formatapplication/pdf
dc.languageeng
dc.publisherSpringer Verlag
dc.rightsrestricted access
dc.subjectAlloimmunization
dc.subjectFetal Anemia
dc.subjectFetal Hydrops
dc.subjectFetal Therapy
dc.subjectIntrauterine Transfusion
dc.subjectPerinatal Loss
dc.subjectAnemia
dc.subjectHidropisia Fetal
dc.subjectTerapias Fetais
dc.subjectTransfusão de Sangue Intrauterina
dc.titleRelationship between obstetric history and rh(d) alloimmunization severity
dc.typeArticle


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