Faculty of Medicine
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Item type:Publication, Epidemiology of RhD alloimmunization in pregnancy in R Macedonia(Medical Faculty, Ss. Cyril and Methodius University in Skopje, 2015); Violeta Dejanova-IlijevskaThe most of the cases of the hemolytic disease of the fetus and the newborn occur in RhD positive newborns, born from RhD negative mothers. If RhD prophylaxis is not implemented, the mother often creates antiD antibodies as a result of small fetal-maternal bleedings during pregnancy and after delivery of the first RhD positive newborn Aim:To present the reasons of the RhD alloimunisation of the woman in pregnancy Material and methods: In the study retrospectively and prospectively are covered 14790 pregnant women, 200 newborns of RhD-negative mothers, 117 fathers of the fetuses/newborns of sensitized RhD-negative women. Tests were done in serum and in erythrocytes from venous blood, no more than 24 hours. From examined 14790 pregnant women, red blood cell antibodies to RhD antigen were detected in 117 pregnant women, with identification of 141 red cell antibodies. Out of these,87 were identified with sensitization only to RhD antigen, whilst in 21 pregnant multiple antibodies were present The analyses of data on the causes for sensitization to the RhD antigen in 117 pregnant women can be grouped into several related groups: 4 pregnant women with routine antenatal anti D profilaksis (ААDP),without history of potential sensitization attack during pregnancy; 15 pregnant women developed antibodies despite conducted postpartum prophylaxis; 21 pregnant women with non-implementation of prophylaxis after sensitizing attack and abortion; 29 pregnant women who did not receive AADP; 7 pregnant women without AADP and postpartum prophylaxis; 19 pregnant as a result of inadequate prophylaxis; 12 pregnant developed sensitization till 28 g.w in the current pregnancy; 10 pregnant with incomplete data. Conclusion: There are special reasons when sensitization occurs in pregnant women: Not recognizing the sensitizing condition during pregnancy, as well as errors in treatment, inability or error in determination of fetomaternal hemorrhage, lack of or disagreement with the existing norms for antenatal and postpartum prophylaxis. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Noninvasive Antenatal Diagnosis of Fetal RhD Status(2018-10-25); Dijana Plaseska-KaranfilskaIntroduction: Fetal cell-free nucleic acids within the blood stream of a pregnant woman come from fetal genetic material which can be acquired by simple venipuncture that reduces any risk to a minimum. Fetal cell-free DNA can be detected in the mother's blood stream in the 5th gestation week at the earliest. That enables fetal genotyping at the earliest possible stage of pregnancy which is best done in the 12th gestation week. Aim: To determine fetal RhD status at RhD negative pregnant women where the father is a heterozygote, Dd. Materials and Methods: The research includes 1540 RhD negative pregnant women, out of which at 30 of them the RhD fetal status had been detected by a PCR technique from the mother’s plasma. The RhD fetal status was confirmed after delivery by serologic analysis at 27 newborn babies. All research patients were submitted to serologic immunohematology testing: blood group typing of red blood cell antigens, screening of irregular anti-red blood cell antibodies. Fetal RhD status was determined by the plasma of RhD negative pregnant women using the real-time PCR technology in the period from the 12th gestation week until the 31 gestation week. The biological fathers of all 30 fetuses were phenotyped as heterozygote to the RhD antigen. The results showed that 30% of the fetuses are RhD negative, and 70% are RhD positive. Conclusion: The noninvasive fetal RhD genotyping is not only one precious tool in the management of RhD alloimmunised pregnancies, but it also allows antenatal anti-D immunoglobulin prophylaxis exclusiveness for only non-immunized RhD pregnant women carrying RhD positive fetus. Taking into consideration that 30% of the RhD negative pregnant women that carry a RhD negative fetus receive antenatal RhIG prophylaxis with no absolute need for it. At RhD alloimmunised pregnant women the noninvasive genotyping of the fetal blood group enables an easy and safe method in determination of a fetal risk from a hemolytic disease, and at the same time evading a vast laboratory and clinical monitoring of RhD antigen-negative fetal cases.