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Antecedents to and Outcomes of Rh(D) Isoimmunization: Mater Mothers Hospital, Brisbane, 1988–1995
Author(s) -
Portmann C.,
Ludlow J.,
Joyce A.,
Chan F.Y.
Publication year - 1997
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1997.tb02210.x
Subject(s) - medicine , obstetrics , pregnancy , rh isoimmunization , blood transfusion , exchange transfusion , amniocentesis , population , psychological intervention , sensitization , gestation , fetus , gynecology , pediatrics , surgery , immunology , nursing , prenatal diagnosis , genetics , environmental health , biology
Summary: We analyzed the antecedents and outcomes of Rh(D) isoimmunization in a local population. Forty‐two Rh(D) isoimmunized women attending Mater Mothers Hospital for antenatal care were identified through the Mater Hospital Blood Bank database; their records were reviewed for variables including sensitizing events, obstetric interventions and pregnancy outcomes. In this group, 74% of women became sensitized despite receiving anti‐D immune globulin, 17% did not receive anti‐D appropriately and the others failed to attend for treatment of bleeding in pregnancy. Antenatal sensitization was implicated in 6 women (14%) and potentially responsible for isoimmunization in another 18. Over half of the 80 viable pregnancies in this study group required some form of obstetric intervention. Thirty pregnancies required amniocentesis and 1 in 3 babies underwent either intrauterine or exchange transfusion. Three fetal deaths occurred as a result of severe disease. This study offers information highlighting circumstances in which immunoprophylaxis guidelines have failed to impart protection against Rh(D) sensitization and the consequences of such failures.