Database : MEDLINE
Search on : rh and isoimmunization [Words]
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  1 / 1922 MEDLINE  
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[PMID]: 29153312
[Au] Autor:Wu J; Huang LH; Luo YM; Fang Q
[Ad] Address:Fetal Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China; Department of Intensive Care Unit, Guizhou Province People's Hospital, Guiyang, Guizhou, China.
[Ti] Title:Discordant intrauterine transfusion in dichorionic twin pregnancy with Rh isoimmunization.
[So] Source:Transfus Apher Sci;, 2017 Nov 07.
[Is] ISSN:1473-0502
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:Discordant intrauterine transfusion (IUT) in twin pregnancy with Rh isoimmunization is uncommon and complicated. We report a gravida 3, para 2 woman with a dichorionic diamniotic (DCDA) twin pregnancy and two fetuses received discordant transfusions. Middle cerebral artery peak systolic velocity (MCA-PSV) was used to evaluate the anemic degree in each foetus. IUT was performed 3 times in twin A and 4 times in twin B to reverse foetal anaemia. Transfusions were distinct due to the different tolerance to IUT, and the procedure could be continued in one foetus even if the other one underwent complications. Two male babies were born at 36 weeks of gestation and were given different treatments after birth. Twins were subsequently healthy after 2 years of follow up. The discordant IUT was due to the different tolerance to transfusion in the DCDA twins. Zygosity is important for the management and treatment of haemolytic anaemia in twin pregnancies.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1711
[Cu] Class update date: 171120
[Lr] Last revision date:171120
[St] Status:Publisher

  2 / 1922 MEDLINE  
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[PMID]: 28718198
[Au] Autor:Haimila K; Sulin K; Kuosmanen M; Sareneva I; Korhonen A; Natunen S; Tuimala J; Sainio S
[Ad] Address:Finnish Red Cross Blood Service, Helsinki, Finland.
[Ti] Title:Targeted antenatal anti-D prophylaxis program for RhD-negative pregnant women - outcome of the first two years of a national program in Finland.
[So] Source:Acta Obstet Gynecol Scand;96(10):1228-1233, 2017 Oct.
[Is] ISSN:1600-0412
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:INTRODUCTION: The aim of this study was to assess the accuracy of the non-invasive fetal RHD test at 24-26 weeks of gestation as part of the national antenatal screening program to target routine antenatal anti-D prophylaxis (RAADP) at 28-30 weeks at women carrying an RhD-positive fetus. MATERIAL AND METHODS: A prospective cohort study involving all maternity care centers and delivery hospitals in Finland between February 2014 and January 2016. Fetal RHD genotyping using cell-free fetal DNA in maternal plasma was performed with real-time polymerase chain reaction in a centralized setting. The results were systematically compared with the serological newborn RhD typing. The main outcome measure was the accuracy of the fetal RHD assay; the secondary variable was compliance with the newly introduced RAADP program. RESULTS: Fetal RHD was screened from 10 814 women. For the detection of fetal RHD, sensitivity was 99.99% [95% confidence interval (CI) 99.92-99.99] and specificity 99.81% (95% CI 99.60-99.92). One false-negative and seven false-positive results were reported by the delivery hospitals in two years. The negative predictive value of the test was 99.97% (95% CI 99.81-99.99). At the end of the study period, over 98% of the RhD-negative women participated in the new screening program. CONCLUSIONS: The targeted RAAPD program was implemented effectively in the national maternity care program in Finland. An accurate fetal RHD screening test allows discontinuation of newborn testing without risking the postnatal prophylaxis program. In the future, the main area to investigate will be the clinical effect of RAADP on subsequent pregnancies.
[Mh] MeSH terms primary: Prenatal Diagnosis/methods
Rh Isoimmunization/diagnosis
Rh Isoimmunization/prevention & control
Rho(D) Immune Globulin/blood
[Mh] MeSH terms secundary: Confidence Intervals
Diagnostic Tests, Routine/statistics & numerical data
Female
Finland
Humans
National Health Programs
Odds Ratio
Pregnancy
Pregnancy Complications, Hematologic/blood
Pregnancy Complications, Hematologic/prevention & control
Rh-Hr Blood-Group System/blood
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Rh-Hr Blood-Group System); 0 (Rho(D) Immune Globulin)
[Em] Entry month:1710
[Cu] Class update date: 171004
[Lr] Last revision date:171004
[Js] Journal subset:IM
[Da] Date of entry for processing:170719
[St] Status:MEDLINE
[do] DOI:10.1111/aogs.13191

  3 / 1922 MEDLINE  
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[PMID]: 28700849
[Au] Autor:Schorge JO; Russo AL; Greene MF; Woythaler MA; Oliva E
[Ad] Address:From the Departments of Obstetrics and Gynecology (J.O.S., M.F.G.), Radiation Oncology (A.L.R.), Pediatrics (M.A.W.), and Pathology (E.O.), Massachusetts General Hospital, and the Departments of Obstetrics, Gynecology, and Reproductive Biology (J.O.S., M.F.G.), Radiation Oncology (A.L.R.), Pediatric
[Ti] Title:Case 21-2017. A 28-Year-Old Pregnant Woman with Endocervical Carcinoma.
[So] Source:N Engl J Med;377(2):174-182, 2017 07 13.
[Is] ISSN:1533-4406
[Cp] Country of publication:United States
[La] Language:eng
[Mh] MeSH terms primary: Carcinoma, Adenosquamous/surgery
Hysterectomy
Pregnancy Complications, Neoplastic/surgery
Uterine Cervical Neoplasms/surgery
[Mh] MeSH terms secundary: Adult
Carcinoma, Adenosquamous/pathology
Carcinoma, Adenosquamous/radiotherapy
Cesarean Section
Combined Modality Therapy
Female
Humans
Neoplasm Staging
Ovariectomy
Pregnancy
Pregnancy Complications, Neoplastic/pathology
Pregnancy Complications, Neoplastic/radiotherapy
Prognosis
Rh Isoimmunization
Salpingectomy
Survival Rate
Uterine Cervical Neoplasms/pathology
Uterine Cervical Neoplasms/radiotherapy
[Pt] Publication type:CASE REPORTS; CLINICAL CONFERENCE; JOURNAL ARTICLE
[Em] Entry month:1707
[Cu] Class update date: 170724
[Lr] Last revision date:170724
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:170713
[St] Status:MEDLINE
[do] DOI:10.1056/NEJMcpc1703511

  4 / 1922 MEDLINE  
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[PMID]: 28639307
[Au] Autor:Quantock KM; Lopez GH; Hyland CA; Liew YW; Flower RL; Niemann FJ; Joyce A
[Ad] Address:Blood Bank Division, Department of Pathology, Mater Health, South Brisbane, Queensland, Australia.
[Ti] Title:Anti-D in a mother, hemizygous for the variant RHD*DNB gene, associated with hemolytic disease of the fetus and newborn.
[So] Source:Transfusion;57(8):1938-1943, 2017 Aug.
[Is] ISSN:1537-2995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Individuals with the partial D phenotype when exposed to D+ red blood cells (RBCs) carrying the epitopes they lack may develop anti-D specific for the missing epitopes. DNB is the most common partial D in Caucasians and the clinical significance for anti-D in these individuals is unknown. STUDY DESIGN AND METHODS: This article describes the serologic genotyping results and clinical manifestations in two group D+ babies of a mother presenting as group O, D+ with alloanti-D. RESULTS: The mother was hemizygous for RHD*DNB gene and sequencing confirmed a single-nucleotide change at c.1063G>A. One baby (group A, D+) displayed bilirubinemia at birth with a normal hemoglobin level. Anti-A and anti-D were eluted from the RBCs. For the next ongoing pregnancy, the anti-D titer increased from 32 to 256. On delivery the baby typed group O and anti-D was eluted from the RBCs. This baby at birth exhibited anemia, reticulocytosis, and hyperbilirubinemia requiring intensive phototherapy treatment from Day 0 to Day 9 after birth and was discharged on Day 13. Intravenous immunoglobulin was also administered. Both babies were heterozygous for RHD and RHD*DNB. CONCLUSION: The anti-D produced by this woman with partial D DNB resulted in a case of hemolytic disease of the fetus and newborn (HDFN) requiring intensive treatment in the perinatal period. Anti-D formed by women with the partial D DNB phenotype has the potential to cause HDFN where the fetus is D+. Women carrying RHD*DNB should be offered appropriate prophylactic anti-D and be transfused with D- RBCs if not already alloimmunized.
[Mh] MeSH terms primary: Erythroblastosis, Fetal/blood
Rh Isoimmunization/complications
Rho(D) Immune Globulin/adverse effects
[Mh] MeSH terms secundary: ABO Blood-Group System/blood
DNA Mutational Analysis
Erythroblastosis, Fetal/pathology
Erythroblastosis, Fetal/therapy
Female
Fetal Diseases
Fetus
Genotype
Humans
Infant, Newborn
Mothers
Polymorphism, Single Nucleotide
Pregnancy
Rh-Hr Blood-Group System/blood
[Pt] Publication type:CASE REPORTS
[Nm] Name of substance:0 (ABO Blood-Group System); 0 (RHO(D) antibody); 0 (Rh-Hr Blood-Group System); 0 (Rho(D) Immune Globulin); 0 (Rho(D) antigen)
[Em] Entry month:1710
[Cu] Class update date: 171010
[Lr] Last revision date:171010
[Js] Journal subset:IM
[Da] Date of entry for processing:170623
[St] Status:MEDLINE
[do] DOI:10.1111/trf.14156

  5 / 1922 MEDLINE  
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[PMID]: 28251113
[Au] Autor:Jain D
[Ad] Address:Department of Obstetrics and Gynecology, Chhotu Ram Hospital, Rohtak, Haryana, India.
[Ti] Title:Rh isoimmunized pregnancy managed noninvasively: A report of two cases.
[So] Source:Int J Appl Basic Med Res;7(1):73-76, 2017 Jan-Mar.
[Is] ISSN:2229-516X
[Cp] Country of publication:India
[La] Language:eng
[Ab] Abstract:Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1703
[Cu] Class update date: 170816
[Lr] Last revision date:170816
[St] Status:PubMed-not-MEDLINE
[do] DOI:10.4103/2229-516X.198535

  6 / 1922 MEDLINE  
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[PMID]: 28191636
[Au] Autor:Arora K; Kelley J; Sui D; Ning J; Martinez F; Lichtiger B; Tholpady A
[Ad] Address:Department of Laboratory Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
[Ti] Title:Cancer type predicts alloimmunization following RhD-incompatible RBC transfusions.
[So] Source:Transfusion;57(4):952-958, 2017 Apr.
[Is] ISSN:1537-2995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: Immunosuppressed, RhD-negative oncology patients tend to have lower rates of sensitization to the D antigen when they receive transfusion with RhD-positive blood components. Clinical factors associated with alloimmunization to the D antigen in RhD-negative oncology patients when they receive transfusion with RhD-positive red blood cells (RBCs) have not been well defined. STUDY DESIGN AND METHODS: This was a 4-year, retrospective analysis identifying RhD-negative oncology patients who received RhD-positive RBCs and were not previously alloimmunized to the D antigen. Age, sex, race, ABO group, primary oncology diagnosis, and numbers of RhD-incompatible RBC transfusions were recorded. The association between antibody formation and clinical factors was studied. The incidence of alloanti-D was calculated from a subsequent antibody-detection test performed at least 28 days after receipt of the first transfusion of RhD-positive RBCs. RESULTS: In total, 545 RhD-negative oncology patients received 4295 RhD-positive RBC transfusions. Of these, 76 (14%) became alloimmunized to the D antigen. Diagnosis type was the only factor significantly associated with responder status. The logistic regression model indicated that patients who had myelodysplastic syndrome or solid malignancies were more likely to be responders than those who had acute leukemia. CONCLUSION: We measured a 14% sensitization rate to the D antigen in our RhD-negative oncology population. The rate of alloimmunization was higher in patients who had solid cancers (22.6%) or myelodysplastic syndrome (23%) compared with those who had other hematologic malignancies (7%). Knowledge of diagnoses that predispose to RhD alloimmunization enables better utilization of RhD-negative RBCs during times of shortage.
[Mh] MeSH terms primary: Erythrocyte Transfusion
Neoplasms/therapy
Rh Isoimmunization/epidemiology
Rh-Hr Blood-Group System/blood
[Mh] MeSH terms secundary: Age Factors
Aged
Female
Humans
Incidence
Male
Middle Aged
Neoplasms/blood
Rh Isoimmunization/blood
Rho(D) Immune Globulin/blood
Sex Factors
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Name of substance:0 (Rh-Hr Blood-Group System); 0 (Rho(D) Immune Globulin)
[Em] Entry month:1706
[Cu] Class update date: 170621
[Lr] Last revision date:170621
[Js] Journal subset:IM
[Da] Date of entry for processing:170214
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13999

  7 / 1922 MEDLINE  
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[PMID]: 28101958
[Au] Autor:McCauley CJ; Morris K; Maguire K
[Ad] Address:Department of Haematology, Belfast City Hospital, Belfast, UK.
[Ti] Title:A review of maternal alloimmunisation to Rh D in Northern Ireland.
[So] Source:Transfus Med;27(2):132-135, 2017 Apr.
[Is] ISSN:1365-3148
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVES: To estimate the current incidence of maternal sensitisation to Rhesus (Rh) D in Northern Ireland, examine adherence to recommendations for administration of anti-D immunoglobulin and identify potential causes for all cases of anti-D alloimmunisation sensitisation from January 2010 to September 2015. BACKGROUND: Post-partum anti-D immunoglobulin administered to Rh D-negative women and routine antenatal anti-D prophylaxis have greatly reduced the incidence of haemolytic disease of the fetus and newborn due to immune anti-D. Despite these measures, anti-D alloimmunisation sensitisation continues to occur, albeit much less frequently than in the past. METHODS/MATERIALS: This was a retrospective review of new sensitisations to Rh D detected in antenatal records between January 2010 and September 2015 in Northern Ireland. A review of patient notes and laboratory data was carried out to examine adherence to standards and identify potential causes of sensitisation. RESULTS: A total of 67 new sensitisations to Rh D were identified over a 69-month period, and the sensitisation rate for the full calendar years 2010-2014 was 0·310%. Only 4% of cases appear to have been preventable, with two cases involving failure to adhere to guidelines. CONCLUSION: A total 96% of sensitisations occurred despite full compliance with guidelines. In a large proportion, sensitisation occurred following delivery (51%). A change in practice in Northern Ireland is under consideration to increase the dose of anti-D immunoglobulin given following delivery from 500 to 1500 U in an attempt to reduce these sensitisations.
[Mh] MeSH terms primary: Postpartum Period
Rh Isoimmunization
Rh-Hr Blood-Group System
Rho(D) Immune Globulin/administration & dosage
[Mh] MeSH terms secundary: Female
Humans
Infant, Newborn
Northern Ireland/epidemiology
Pregnancy
Retrospective Studies
Rh Isoimmunization/drug therapy
Rh Isoimmunization/epidemiology
[Pt] Publication type:JOURNAL ARTICLE
[Nm] Name of substance:0 (Rh-Hr Blood-Group System); 0 (Rho(D) Immune Globulin); 0 (Rho(D) antigen)
[Em] Entry month:1707
[Cu] Class update date: 170724
[Lr] Last revision date:170724
[Js] Journal subset:IM
[Da] Date of entry for processing:170120
[St] Status:MEDLINE
[do] DOI:10.1111/tme.12387

  8 / 1922 MEDLINE  
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[PMID]: 28081297
[Au] Autor:Xiong Y; Jeronis S; Hoffman B; Liebermann DA; Geifman-Holtzman O
[Ad] Address:Fels Institute for Cancer Research and Molecular Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, USA.
[Ti] Title:First trimester noninvasive fetal RHD genotyping using maternal dried blood spots.
[So] Source:Prenat Diagn;37(4):311-317, 2017 Apr.
[Is] ISSN:1097-0223
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: This study was aimed to evaluate whether maternal dried blood spots could be a potential source for the noninvasive fetal RHD genotyping, serving as a combined one-step test for both the First Trimester Screen and the fetal RHD genotyping. METHOD: Both the maternal dried blood spots and the peripheral blood samples from 19 RhD-negative pregnant women were obtained during the First Trimester Screen. DNA was extracted and sequential real-time PCRs were performed to determine the fetal RHD genotypes. Fetal RhD serological types were obtained after delivery. This study was approved by the Institutional Review Board, and informed consents were obtained. RESULTS: A total of 19/19 fetal RHD genotyping with maternal DBS were consistent with the follow-up serological RhD test results after birth. Eleven were RhD positive, and eight were RhD negative (RHD deletion or RHD-CE-D = 6, RHD pseudogene = 1, RHDVI = 1). Sensitivity = 100%, specificity = 100%, positive predictive value = 100%, negative predictive value = 100%. A total of 18/19 fetal gender were determined correctly with maternal DBS. One female fetus was falsely determined as male. Sensitivity = 100%, specificity = 91.6%, positive predictive value = 87.5%, negative predictive value = 100%. CONCLUSION: Maternal dried blood spots, with the benefits of flexible sample transportation and processing, could be utilized for the noninvasive prenatal fetal RHD genotyping and potentially be incorporated into the routine First Trimester Screen. Larger scale study is in progress to implement fetal RHD genotyping in routine prenatal care. © 2017 John Wiley & Sons, Ltd.
[Mh] MeSH terms primary: Dried Blood Spot Testing
Fetal Diseases/diagnosis
Pregnancy Trimester, First/blood
Prenatal Diagnosis/methods
Rh-Hr Blood-Group System/blood
[Mh] MeSH terms secundary: Female
Fetal Diseases/blood
Genotype
Genotyping Techniques/methods
Humans
Male
Mothers
Pregnancy
Real-Time Polymerase Chain Reaction
Rh Isoimmunization/blood
Rh-Hr Blood-Group System/analysis
Sensitivity and Specificity
[Pt] Publication type:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Name of substance:0 (Rh-Hr Blood-Group System)
[Em] Entry month:1709
[Cu] Class update date: 170929
[Lr] Last revision date:170929
[Js] Journal subset:IM
[Da] Date of entry for processing:170113
[St] Status:MEDLINE
[do] DOI:10.1002/pd.5006

  9 / 1922 MEDLINE  
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Visentainer, Jeane Eliete Laguila
Costa, Fernando Ferreira
Full text

[PMID]: 27873324
[Au] Autor:Sippert EÂ; Visentainer JE; Alves HV; Rodrigues C; Gilli SC; Addas-Carvalho M; Saad ST; Costa FF; Castilho L
[Ad] Address:Hematology and Hemotherapy Center, State University of Campinas, UNICAMP, Campinas, São Paulo, Brazil.
[Ti] Title:Red blood cell alloimmunization in patients with sickle cell disease: correlation with HLA and cytokine gene polymorphisms.
[So] Source:Transfusion;57(2):379-389, 2017 Feb.
[Is] ISSN:1537-2995
[Cp] Country of publication:United States
[La] Language:eng
[Ab] Abstract:BACKGROUND: The reason for the difference in susceptibility to red blood cell (RBC) alloimmunization among patients with sickle cell disease (SCD) is not clearly understood and is probably the result of multiple factors. Our hypothesis is that genetic polymorphisms are associated with RBC alloimmunization. STUDY DESIGN AND METHODS: We investigated the possible association of susceptibility to RBC alloimmunization with polymorphisms of HLA and cytokines genes in 161 SCD patients prior exposed to RBC transfusion. Cytokine gene polymorphisms were analyzed by polymerase chain reaction (PCR) and TaqMan assays. HLA Class I genotyping was performed using PCR-specific sequence of oligonucleotides. Polymorphism frequencies were compared using the Fisher's exact test. RESULTS: Our results revealed increased percentage of the A allele and the GA genotype of the TNFA -308G/A cytokine among alloimmunized patients when compared to nonalloimmunized patients (A allele, 16.4% vs. 6.8%, p = 0.004; GA genotype, 32.8% vs. 11.7%, p = 0.0021). In addition, the IL1B -511T allele and the IL1B -511TT and CT genotype frequencies were overrepresented among alloimmunized patients (T allele, 53.0% vs. 37.5%, p = 0.0085; CT + TT genotypes, 81.82% vs. 60.87%, p = 0.0071). In relation to HLA Class I, we found a higher frequency of HLA-DRB1*15 among patients alloimmunized to Rh antigens when compared to nonalloimmunized patients (15.63% vs. 6.98%, p = 0.044). CONCLUSION: Brazilian SCD patients with the TNFA, IL1B, and HLA-DRB1 gene polymorphisms were at increased risk of becoming alloimmunized by RBC transfusions. These findings may contribute to the development of future therapeutic strategies for patients with SCD with higher susceptibility of alloimmunization.
[Mh] MeSH terms primary: Anemia, Sickle Cell
HLA-DRB1 Chains/genetics
Interleukin-1beta/genetics
Polymorphism, Genetic
Rh Isoimmunization/genetics
Tumor Necrosis Factor-alpha/genetics
[Mh] MeSH terms secundary: Adolescent
Adult
Aged
Anemia, Sickle Cell/genetics
Anemia, Sickle Cell/therapy
Child
Child, Preschool
Female
Humans
Male
Middle Aged
Risk Factors
[Pt] Publication type:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Name of substance:0 (HLA-DRB1 Chains); 0 (HLA-DRB1*15 antigen); 0 (IL1B protein, human); 0 (Interleukin-1beta); 0 (Tumor Necrosis Factor-alpha)
[Em] Entry month:1706
[Cu] Class update date: 170621
[Lr] Last revision date:170621
[Js] Journal subset:IM
[Da] Date of entry for processing:161123
[St] Status:MEDLINE
[do] DOI:10.1111/trf.13920

  10 / 1922 MEDLINE  
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[PMID]: 27664264
[Au] Autor:Wallace AH; Dalziel SR; Cowan BR; Young AA; Thornburg KL; Harding JE
[Ad] Address:Liggins Institute, University of Auckland, Auckland, New Zealand.
[Ti] Title:Long-term cardiovascular outcome following fetal anaemia and intrauterine transfusion: a cohort study.
[So] Source:Arch Dis Child;102(1):40-45, 2017 Jan.
[Is] ISSN:1468-2044
[Cp] Country of publication:England
[La] Language:eng
[Ab] Abstract:OBJECTIVE: To compare long-term cardiovascular outcomes in survivors of fetal anaemia and intrauterine transfusion with those of non-anaemic siblings. DESIGN: Retrospective cohort study. SETTING: Auckland, New Zealand. PARTICIPANTS: Adults who received intrauterine transfusion for anaemia due to rhesus disease (exposed) and their unexposed sibling(s). EXPOSURE: Fetal anaemia requiring intrauterine transfusion. MAIN OUTCOME MEASURES: Anthropometry, blood pressure, lipids, heart rate variability and cardiac MRI, including myocardial perfusion. RESULTS: Exposed participants (n=95) were younger than unexposed (n=92, mean±SD 33.7±9.3 vs 40.1±10.9 years) and born at earlier gestation (34.3±1.7 vs 39.5±2.1 weeks). Exposed participants had smaller left ventricular volumes (end-diastolic volume/body surface area, difference between adjusted means -6.1, 95% CI -9.7 to -2.4 mL/m ), increased relative left ventricular wall thickness (difference between adjusted means 0.007, 95% CI 0.001 to 0.012 mm.m /mL) and decreased myocardial perfusion at rest (ratio of geometric means 0.86, 95% CI 0.80 to 0.94). Exposed participants also had increased low frequency-to-high frequency ratio on assessment of heart rate variability (ratio of geometric means 1.53, 95% CI 1.04 to 2.25) and reduced high-density lipoprotein concentration (difference between adjusted means -0.12, 95% CI -0.24 to 0.00 mmol/L). CONCLUSIONS: This study provides the first evidence in humans that cardiovascular development is altered following exposure to fetal anaemia and intrauterine transfusion, with persistence of these changes into adulthood potentially indicating increased risk of cardiovascular disease. These findings are relevant to the long-term health of intrauterine transfusion recipients, and may potentially also have implications for adults born preterm who were exposed to anaemia at a similar postconceptual age.
[Mh] MeSH terms primary: Anemia/therapy
Cardiovascular Diseases/embryology
Fetal Diseases/therapy
[Mh] MeSH terms secundary: Adult
Anemia/embryology
Blood Transfusion, Intrauterine
Female
Heart Rate/physiology
Humans
Longitudinal Studies
Magnetic Resonance Angiography
Male
Pilot Projects
Rh Isoimmunization/therapy
Risk Factors
Stroke Volume/physiology
Ventricular Function, Left/physiology
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1706
[Cu] Class update date: 170605
[Lr] Last revision date:170605
[Js] Journal subset:AIM; IM
[Da] Date of entry for processing:160925
[St] Status:MEDLINE
[do] DOI:10.1136/archdischild-2016-310984


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