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[Diagnostic and therapeutic proceedings in pregnancies with blood group incompatibility: A retrospective analysis
T Müller1, J Hofmann, P Kristen
1Universitäts-Frauenklinik und Hebammenschule Würzburg, Germany. t.muellerdog@mail.uni-wuerzburg.de
Purpose:
To examine the development during the past 30 years of diagnostic and therapeutic procedures in pregnancies with blood group incompatibility.
Patients And Methods:
We evaluated 193 pregnancies with maternal red blood alloimmunisation treated at our hospital. At least one amniotic fluid spectrophotometry was performed.
Results:
We observed a reduced average age of the patients, a reduced parity and an increase in the number of amniotic fluid examinations per pregnancy in the course of time. Amniotic fluid examinations tended to be performed earlier in pregnancy. Gestational time was reduced, the rate of spontaneous vaginal deliveries remained unchanged. The proportion of anti-D-alloimmunisation decreased in relation to other antigens and the severity of the cases increased (assessed according to the findings of the spectrophotometric amniotic fluid examinations performed while using the semiquantitative method of Liley). The haemoglobin values of the newborn, without intrauterine transfusions, were unchanged and the number of intrauterine deaths decreased. The rate of postnatal transfusions decreased dramatically, whereas the rate of phototherapeutic approaches increased.
Conclusion:
The spectrum of the antigens causing fetal haemolytic disease has changed during the last 30 years and so have the diagnostic and therapeutic procedures.