Mechanisms of Isoimmunization. I. The Transplacental Passage of Fetal Erythrocytes in Homospecific Pregnancies

Cohen, Flossie; Zuelzer, Wolf W.; Gustafson, David C.; Evans, Margaret D. M.

doi:10.1097/00006254-196410000-00004

Cited by 30 publications

(49 citation statements)

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“…It is reported that about one-half of women have fetal red cells demonstrable by KBT in the maternal circulation in the antenatal period [7] , while in the third trimester the incidence increases to 71% [8] . In a previous study done at our center, all the 61 patients had detectable FMH following chorionic villous sampling using KBT [9] .…”

Section: Discussionmentioning

confidence: 99%

Assessment of Fetomaternal Hemorrhage by Flow Cytometry and Kleihauer-Betke Test in Rh-Negative Pregnancies

Savithrisowmya¹,

Singh

Kriplani³

et al. 2007

Gynecol Obstet Invest

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Objectives: To assess the efficacy of flow cytometry (FC) in the detection and quantification of fetomaternal hemorrhage (FMH) in comparison to the Kleihauer-Betke test (KBT). Methods: 25 unsensitized Rh-negative mothers who had delivered Rh-positive infants were included. Presence of FMH was determined by KBT and FC using FITC-labeled BRAD-3 antibodies. Results: FMH was detected in 19 (76%) patients by FC and 23 (92%) patients by KBT prior to delivery, and in 21 (84%) patients by FC and 23 (92%) patients by KBT after delivery. The mean volume of FMH in the post-delivery samples by KBT and FC were 0.34 ± 0.26 ml (range 0.05–1.2 ml) and 0.37 ± 0.57 ml (range 0.02–2.6 ml) respectively. The volume of post-delivery FMH estimated by KBT and FC correlated well (r = 0.75; ICC α = 0.73). A higher agreement between KBT and FC was seen in the 0.1–0.5 ml range (ĸ = 0.65; p < 0.01). Conclusions: Both manual KBT and FC using FITC-BRAD-3 antibodies show good sensitivity in detecting and quantifying fetal red cells. There is a good correlation between the methods in the 0.1- to 0.5-ml range of FMH.

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Section: Discussionmentioning

confidence: 99%

Assessment of Fetomaternal Hemorrhage by Flow Cytometry and Kleihauer-Betke Test in Rh-Negative Pregnancies

Savithrisowmya¹,

Singh

Kriplani³

et al. 2007

Gynecol Obstet Invest

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“…In separate experiments, pregnant rats were injected 1-2 days before birth of their litters; blood was collected from the newborn a t 5 days of age, washed, transfused into normal adult hosts, and R B C survival determined from the resultant I4CO production. When compared with adult RBC, in situ survival of fetallv produced R B C was 2 2 % of normal (mean suggested for fetal R B C by following the rate of fall of fetal hemoglobin levels in fully compatible mothers autotransfused during the prenatal period (4,15).Recent studies of R B C destruction in the newborn dog (12) suggest a rapid elimination of fetally produced R B C during the immediate postnatal period. Since R B C survival is shorter in the premature infant than in the full term, and appears to decrease with decreasing birth weight (7).…”

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confidence: 99%

Shortened Survival of Fetal Erythrocytes in the Rat

Landaw

Guancial

1977

Pediatr Res

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SummaryOne to 4 days before birth of their litters, pregnant buffalo rats were injected intravenously with 200 p C i of [2-I4C]glycine in order to label a cohort of fetally produced red blood cells (RBC). Shortly after birth, the newborn rats were transferred to noninjected foster mothers, and R B C survival was determined by the rate of production of 14C0 in the expired air of the newborn animals. In separate experiments, pregnant rats were injected 1-2 days before birth of their litters; blood was collected from the newborn a t 5 days of age, washed, transfused into normal adult hosts, and R B C survival determined from the resultant I4CO production. When compared with adult RBC, in situ survival of fetallv produced R B C was 2 2 % of normal (mean suggested for fetal R B C by following the rate of fall of fetal hemoglobin levels in fully compatible mothers autotransfused during the prenatal period (4,15).Recent studies of R B C destruction in the newborn dog (12) suggest a rapid elimination of fetally produced R B C during the immediate postnatal period. Since R B C survival is shorter in the premature infant than in the full term, and appears to decrease with decreasing birth weight (7). it has been concluded that R B C produced before birth have a markedly shortened survival, whereas those produced after birth have either slightly shortened or normal survival (2). The present study was undertaken in order to test this assumption by following the in situ survival of R B C produced in utero, using a noneluting cohort technique.life span of 12.1 d a i s i n the fetus, and 54.5 + 1.5 (SE) days in MATERIALS A N D METHODS the adult). This shortening of survival resulted from a n acceleration of R B C senescence (15.7 days for fetal R B C and 66.2 & 0.7 A11 studies were performed in specific pathogen-free highly days for adult RBC) and a n increased rate of random hemolysis inbred buffalo rats (Simonsen Laboratories, Gilroy, Calif.). (3.70%/day in the fetal R B C and 0.67 & 0.07%/day in adult Pregnant rats were injected intravenously with 200 p C i of [2-RBC). Although cross-transfusion of adult R B C into compatible '4C]glycine (New England Nuclear, Boston, Mass.) under light adult rat hosts resulted in only a modest shortening of R B C ether anesthesia 24-96 hr before birth of their litters. Timing of 1 lifespan (mean R B C survival reduced from 54.5 + 1.5 days to these injections was facilitated by knowledge of the time of 52.8 + 0.8 days), similar treatment of fetally produced R B C appearance of a vaginal postcoital plug. However, the variation resulted in a marked acceleration of senescence from 15.7 days in delivery times for animals with similar appearance times of t o 5.8 days. Examination of the R B C survival curves for those vaginal plugs indicated that frequent abdominal palpation and litters injected less than 7 2 hr before birth indicated the presence inspection was a more reliable indicator of impending delivery. of an additional population of cells with survival in the range of After birth of the l...

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“…Approximately 0.1-0.2% of Rh-negative women will have evidence of Rh isoimmunization prior to 28 week's gestation [4], The presence of fetal red blood cells in the maternal blood increases throughout gestation. In random samples obtained from 161 mothers during pregnancy, Cohen et al [5] found fetal red blood cells in the maternal circula tion using the K-B test in increasing frequency from the end of the first trimester. Fetal cells were found in 6.7% of the first trimester samples, 15.9% in the second trimester, and 28.9% in the third trimester.…”

Section: Discussionmentioning

confidence: 99%

The Frequency of Transplacental Hemorrhage in Patients with Threatened Abortions

Kuller

Laifer²,

Portney³

et al. 1994

Gynecol Obstet Invest

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The frequency and volume of transplacental hemorrhage that occurs with threatened abortions is unknown. The use of Rh immune globulin for such patients is therefore undefined. We studied the incidence and quantity of transplacental hemorrhage in patients with threatened abortions and in a control population of patients presenting in the first 20 weeks of pregnancy without a history of bleeding. Using the Kleihauer-Betke test, the incidence of transplacental hemorrhage in our control and study population was not statistically different.

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Mechanisms of Isoimmunization. I. The Transplacental Passage of Fetal Erythrocytes in Homospecific Pregnancies

Cited by 30 publications

References 0 publications

Assessment of Fetomaternal Hemorrhage by Flow Cytometry and Kleihauer-Betke Test in Rh-Negative Pregnancies

Assessment of Fetomaternal Hemorrhage by Flow Cytometry and Kleihauer-Betke Test in Rh-Negative Pregnancies

Shortened Survival of Fetal Erythrocytes in the Rat

The Frequency of Transplacental Hemorrhage in Patients with Threatened Abortions

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