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[Preventive anti-D after massive fetomaternal hemorrhage]
E Strobel1, G Hofmeister, J Wüllenweber
1Institut für Medizinische Mikrobiologie, Immunologie und Krankenhaushygiene, Städtisches Krankenhaus München-Schwabing.
Geburtshilfe Und Frauenheilkunde
|April 1, 1995
Summary
A massive fetomaternal hemorrhage occurred in a Rh-negative mother carrying twins. Prompt Rh immunoglobulin (RhIG) administration prevented Rhesus (D) sensitization, safeguarding future pregnancies.
Area of Science:
- Obstetrics and Gynecology
- Immunology
- Hematology
Context:
- Intrauterine fetal demise of twins in a 31-year-old primigravida at 36 weeks gestation.
- Mixed field agglutination identified a significant fetomaternal macrotransfusion.
Purpose:
- To report a case of massive fetomaternal hemorrhage (FMH) in a Rh-negative patient.
- To evaluate the efficacy of Rh immunoglobulin (RhIG) prophylaxis in preventing RhD sensitization following FMH.
Summary:
- A Rh-negative mother experienced a massive FMH (estimated 440 ml) after intrauterine twin demise.
- Treatment with 17 doses of anti-D immunoglobulin intramuscularly over 4 days.
- Fetal hemoglobin levels decreased significantly, and no RhD sensitization was detected at 9 months post-treatment.
Impact:
- Demonstrates successful prevention of RhD sensitization despite a large fetomaternal hemorrhage.
- Highlights the importance of timely Rh immunoglobulin administration in high-risk obstetric cases.
- Provides evidence for the safety and efficacy of RhIG in preventing hemolytic disease of the newborn in subsequent pregnancies.