Red blood cell alloimmunization prevalence and hemolytic disease of the fetus and newborn in Israel: A retrospective study

Rahimi‐Levene, Naomi; Chezar, Judith; Yahalom, Vered

doi:10.1111/trf.15987

Cited by 15 publications

(12 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…While there have been reports suggestive of increased severity of fetal anemia based on type of antibody, especially in cases of Kell antibodies or the presence of multiple antibodies [15][16][17][18][19], our study did not demonstrate any difference in mode of transfusion based on type of antibody or number of antibodies detected. Several studies have reviewed the complications from IUTs which include preterm premature rupture of membranes, infection, preterm delivery, demise, and need for emergency cesarean section [5,[20][21][22].…”

Section: Discussioncontrasting

confidence: 93%

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Donepudi,

Jouannic,

Maisonneuve

et al. 2023

Fetal Diagn Ther

View full text Add to dashboard Cite

Introduction: Fetal anemia from hemolytic disease treated by intrauterine transfusion (IUT) can be performed by intraperitoneal, intracardiac and intravascular transfusion (IVT). Objective of our study was to compare different transfusion techniques. Methods: Retrospective review of IUT secondary to red cell alloimmunization at eight international centers from 2012-2020. Severe anemia suspected if middle cerebral artery peak systolic velocity  1.5 MoM. Demographic, delivery and postnatal variables were analyzed. Results: Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs 15.8%, p=0.7), prior pregnancy IUT (25.6 vs 31.6%, p=0.5) or neonatal transfusion (36.1 vs 43.8%, p=0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p=0.03), lower starting hematocrit (13.3% (±6) vs. 17.7% (±8.2), p = 0.04) and trend towards lower gestational age (24.6 (20.1-27) vs. 26.4 (23.2-29.6) weeks, p=0.08). No difference in birthweight, neonatal phototherapy, exchange or simple transfusion. Conclusion: This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops and lower starting hematocrit was seen. Neither technique affected outcomes. This study may suggest that physician’s experience may be the strongest contributor of outcomes.

show abstract

Section: Discussioncontrasting

confidence: 93%

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Donepudi,

Jouannic,

Maisonneuve

et al. 2023

Fetal Diagn Ther

View full text Add to dashboard Cite

show abstract

“…This findings is in agreement with previous reports of Gothwal and colleagues reported that (3.119%) of pregnant women were alloimmunized with specificity of anti-M (9.23%), anti-c (3.076%), anti-E (1.538%), anti-e (1.538%), anti-Lewis (a) (1.538%), unspecified antibodies (1.538%), multiple antibodies anti-D and anti-C (3.076%), anti-e and anti-c (1.538%), and anti-D and anti-G (1.538%) in tertiary care centre of Western India [11] and that of Karim and colleagues in Pakistan reported the frequency of maternal alloimmunization among pregnant women was 1.8% of with specificity of non-anti-D (1.6%), anti-M (15%), anti-Lewis(a) (15%), anti-c (5%), anti-E (5%), anti-e (5%), anti-Lewis(b) (5%) and nonspecific antibodies (30%) and the prevalence of anti-D 2.9% in D negative blood type [12] as well as the report of [13] Ugandan who reported that 2•2% of pregnant women were alloimmunized to RBC antigens with specificity including anti-S, 12; anti-M, 11; anti-Lea, 6; anti-D, 4 and 1 each of anti-K, anti-Fyb, anti-Jka, anti-Lua and anti-Kpa. [14] in isreal also reported that 5.8% of the pregnant women had antibody with specificity of anti-E (23%), anti-K (16%), and anti-c (10.8%) and multiple alloantibodies were observed in 15% of women and severe HDFN developed in 6.8% of these pregnancies. "Although the subjects are not the same, the finding are also in agreement with another previous report that reported 6.5% antibody screening positive with 13 RBC antibodies against antigens in the Rh system some had multiple antibodies, M antigen, and one against a low frequency antigen of unknown specificity" [15].…”

Section: Resultsmentioning

confidence: 92%

Distribution of Maternal Red Cell Antibodies and the Risk of Haemolytic Disease of the Foetus and Newborn in Sokoto Nigeria

Buhari

Sagir²,

Akuyam³

et al. 2022

JOCAMR

View full text Add to dashboard Cite

Background: The incidence is still of clinical importance because sensitization of the mother may occur through the placenta, blood transfusion, miscarriage, ectopic pregnancy, amniocentesis as well as lack of prophylaxis of alloantibody except RhD. Aim: The aim of this study is to determine the prevalence of clinically significant red blood cell alloantibodies among pregnant women. Study Design: This was a cross- sectional study. Duration of Study: The study lasted for a period of one year between January to December, 2021. Methodology: About 1250 consecutively recruited pregnant women were screened for alloantibody and identification was done to determine the specificity of the antibody using NHSBT reagent with column agglutination card technology. Results: Among the 1250 apparently healthy pregnant women studied, 73(5.8%) had alloantibodies with specificity as follows: Multiple antibody of C, E 3 (4.1%), D 23 (31.5%), C 6(8.2%), E 5(6.8%), e (1.4%), Jka 2 (2.7%), Jkb 2 (2.7), M 1 (1.4%), S 1 (1.4%), Lea 7 (9.6%), Leb 8 (11%), I 4 (5.5%), and Lu 7 (9.6%). When the demographic and obstetric characteristics were compared with the presence of alloantibodies, statistically significant differences were observed in gestational age, past history of pregnancy, preeclampsia, and previous baby delivered with jaundice and previous administration of anti-D prophylaxis. Conclusion: There is high prevalence of alloantibody among pregnant women that may be linked to lack of premarital testing to know couple at risk and lack of standard protocol of alloantibody testing.

show abstract

“…The mean ± SD prevalence of Rh(D)-mediated HDFN (requiring any form of treatment) as reported in 5 studies [ 23 , 29 , 45 , 47 , 54 ] was 0.047%±0.037% among all pregnancies that were managed and delivered in the centers of the 5 selected studies (Fig. 2 ).…”

Section: Resultsmentioning

confidence: 99%

Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape

Winter

Kaminski

Tjoa

et al. 2023

BMC Pregnancy Childbirth

View full text Add to dashboard Cite

Background Prevention of pregnancy-related alloimmunization and the management of hemolytic disease of the fetus and newborn (HDFN) has significantly improved over the past decades. Considering improvements in HDFN care, the objectives of this systematic literature review were to assess the prenatal treatment landscape and outcomes of Rh(D)- and K-mediated HDFN in mothers and fetuses, to identify the burden of disease, to identify evidence gaps in the literature, and to provide recommendations for future research. Methods We performed a systematic search on MEDLINE, EMBASE and clinicaltrials.gov. Observational studies, trials, modelling studies, systematic reviews of cohort studies, and case reports and series of women and/or their fetus with HDFN caused by Rhesus (Rh)D or Kell alloimmunization. Extracted data included prevalence; treatment patterns; clinical outcomes; treatment efficacy; and mortality. Results We identified 2,541 articles. After excluding 2,482 articles and adding 1 article from screening systematic reviews, 60 articles were selected. Most abstracted data were from case reports and case series. Prevalence was 0.047% and 0.006% for Rh(D)- and K-mediated HDFN, respectively. Most commonly reported antenatal treatment was intrauterine transfusion (IUT; median frequency [interquartile range]: 13.0% [7.2–66.0]). Average gestational age at first IUT ranged between 25 and 27 weeks. weeks. This timing is early and carries risks, which were observed in outcomes associated with IUTs. The rate of hydrops fetalis among pregnancies with Rh(D)-mediated HDFN treated with IUT was 14.8% (range, 0–50%) and 39.2% in K-mediated HDFN. Overall mean ± SD fetal mortality rate that was found to be 19.8%±29.4% across 19 studies. Mean gestational age at birth ranged between 34 and 36 weeks. Conclusion These findings corroborate the rareness of HDFN and frequently needed intrauterine transfusion with inherent risks, and most births occur at a late preterm gestational age. We identified several evidence gaps providing opportunities for future studies.

show abstract

Red blood cell alloimmunization prevalence and hemolytic disease of the fetus and newborn in Israel: A retrospective study

Cited by 15 publications

References 26 publications

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Distribution of Maternal Red Cell Antibodies and the Risk of Haemolytic Disease of the Foetus and Newborn in Sokoto Nigeria

Hemolytic disease of the fetus and newborn: systematic literature review of the antenatal landscape

Contact Info

Product

Resources

About