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[Perinatal hemolytic disease. Part 2: Prevention and management]
P Hohlfeld1, D Wirthner, J D Tissot
1Département de Gynécologie et Obstétrique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Suisse.
Summary
Rhesus prophylaxis has significantly reduced neonatal deaths from hemolytic disease. This review details antibody detection, fetal management including ultrasound and intrauterine transfusions, and postnatal care for hemolytic disease.
Area of Science:
- Immunology
- Obstetrics
- Neonatology
Context:
- The introduction of Rhesus prophylaxis has dramatically decreased neonatal mortality from hemolytic disease.
- Despite widespread use since 1968, the precise mechanism of anti-D immunoglobulin G (IgG) remains incompletely elucidated.
- Significant progress has been made in screening and managing hemolytic disease of the fetus and newborn.
Purpose:
- To review the diagnostic and management strategies for hemolytic disease of the fetus and newborn.
- To describe antibody detection in maternal serum.
- To outline fetal management techniques and postnatal care.
Summary:
- This article discusses the detection of anti-D antibodies in mothers at risk of Rh alloimmunization.
- It details fetal management strategies, including ultrasound-guided amniocentesis, fetal blood sampling, and intrauterine transfusions.
- Postnatal care protocols for affected newborns are also considered.
Impact:
- Provides a comprehensive overview of current practices in managing hemolytic disease of the fetus and newborn.
- Highlights the importance of timely diagnosis and intervention.
- Contributes to understanding the ongoing management of this condition despite advances in prophylaxis.