Sermet SAĞOL, Fuat AKERCAN, Solmaz Pınar YILDIZ, Mert KAZANDI, Teksin ÇIRPAN

Rhesus alloimmunizasyonu olan gebeliklere yaklaşım: Olgu sunumu

Rh uyuşmazlığına bağlı oluşan hemolitik hastalık, geçmişte perinatal mortalite ye morbiditenin önemli bir sebebiydi. Son 50 yıl içinde takip ve tedavide ortaya çıkan gelişmelerle, insidans hızla azalarak 1000 doğumda 1-6'lara kadar inmiştir. Bu yayında kliniğimizde hidrops fetalis tanısı almış iki olgu bildirilmiş ve rhesus alloimmunizasyonu olan gebeliklerdeki yaklaşım tartışılmıştır.

Anahtar Kelimeler:

Gebelik komplikasyonları, Kan grubu uyumsuzluğu, Rh uyuşmazlığı, Hidrops fetalis, Kan nakli, intrauterin

Management of the pregnancies complicated with RH alloimmunization: Report of a case

Haemolytic disease of the fetus due to Rh alloimmunization was one of the major cause of the perinatal mortality and morbidity in the past. The incidence has decreased to 1-6 /1000 birth in last 50 years because of the development in the management and therapy of the disease. In this report, the management of the Rh isoimmunization were discussed in the light of two different hydrops fetalis cases, diagnosed at our department.

Keywords:

Pregnancy Complications, Blood Group Incompatibility, Rh Isoimmunization, Hydrops Fetalis, Blood Transfusion, Intrauterine,

PDF

___

1- Kenneth J, Moise Jr. Management of Rhesus Alloimmunization in Pregnancy. Obstet Gynecol 2002;100:600-11.
2- De Cherney AH, Nathan L. Current Obstetric&Gynecologic Diagnosis&Treatment. Ninth edition International Edition 2003:295-299
3- Bowman J, Pollock JM, Penston LE. Fetomaternal transplacental hemorrhage during pregnancy and after delivery. Vox Sang 1986;51:117-21.
4- Liley AW. Liquor amnii analysis in the management of pregnancy complicated by rhesus sensitization. Am J Obstet Gynecol 1961;82:1359-70.
5- Queenan JT, Tomai TP, Ural SH, King JC. Deviation in amniotic fluid optical density at a wawelwnght of 450 nm in Rh immunized pregnancies from 14 to 40 weeks’ gestation: A proposal for clinical management. Am J Obstet Gynecol 1993;168:1370-6.
6- Liley AW. Intrauterine transfusion of foetus in haemolytic disease. Br Med J 1963;2:1107-9.
7- Gonsoulin WJ, Moise KJ, Milam JD, Sala JD, Weber Wv, Carpenter RJ. Serial maternal blood donations for intrauterine transfusion. Obstet Gynecol 1990;75:158-62.
8- Schumacher B, Moise KJ. Fetal transfusion for red blood cell alloimmunization in pregnancy. Obstet Gynecol 1996;88:137-50.
9- Moise KJ, Whitecar PW. Antenatal therapy for haemolytic disease of the fetus and newborn. In: Hadley A, Soothill P, eds. Alloimmune disorders in pregnancy. Anemia, thrombocytopenia and netropenia in the fetus and newborn. Cambridge, UK: Cambridge University Pres, 2002:141-63.
10- Hudon L, Moise KJ, Hegemier SE, et al. Long-term neurodevelopmental outcome after intrauterine transfusion for the treatment of fetal hemolytic disease. Am J Obstet Gynecol 1998;179:858-63.