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Postnatal outcome in neonates with severe R hesus c compared to R hesus D hemolytic disease
Author(s) -
Rath Mirjam E.A.,
SmitsWintjens Vivianne E.H.J.,
Lindenburg Irene T.M.,
Folman Claudia C.,
Brand Anneke,
Kamp Inge L.,
Oepkes Dick,
Walther Frans J.,
Lopriore Enrico
Publication year - 2013
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2012.03937.x
Subject(s) - interquartile range , medicine , exchange transfusion , haemolytic disease , gestational age , fetus , gastroenterology , pediatrics , pregnancy , biology , genetics
Background Neonates with R hesus c ( Rh c ) hemolytic disease of the fetus and newborn ( HDFN ) are often managed in the same way as neonates with R hesus D ( Rh D ) HDFN , although evidence to support this policy is limited. The objective of this study was to evaluate neonatal outcome in severe Rh c HDFN compared to Rh D HDFN . Study Design and Methods A retrospective study of (near‐)term neonates with severe Rh c (n = 22) and Rh D HDFN (n = 103; without additional antibodies) admitted to the L eiden U niversity M edical C enter between J anuary 2000 and O ctober 2011 was conducted. The need for intrauterine transfusions ( IUTs ), phototherapy, exchange transfusions ( ETs ), and top‐up transfusions up to 3 months of age were recorded and compared between both groups. Results Although there was a trend for a slightly more severe antenatal course for Rh D HDFN reflected by an earlier need for and higher number of IUT s (median [interquartile range], 2 [1.5‐4] vs. 2 [1‐2] in Rh c HDFN ; p = 0.070), no significant differences were found for the postnatal course between Rh c and Rh D group in days of phototherapy (mean, Days 4.8 and 4.6, respectively; p = 0.569), need for ET (50% vs. 44%, respectively; p = 0.589), and top‐up transfusions (62% vs. 78%, respectively; p = 0.128). Conclusion Postnatal outcome in neonates with severe Rh c HDFN is similar compared to neonates with severe Rh D hemolytic disease in terms of days of phototherapy, need for ET, and need for top‐up transfusions. These results justify a similar postnatal management of neonates with Rh D and Rh c HDFN .