Epidemiology of RhD alloimmunization in pregnancy in R Macedonia

Abstract

The 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.