Acta Obstetricia et Gynecologica Scandinavica
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Alloimmunization in pregnancy during the years 1992-2005 in the central west region of Sweden
Tomas Gottvall a; Derek Filbey b a Department of Obstetrics and Gynecology, University Hospital, Örebro, Sweden b Department of Transfusion Medicine, University Hospital, Örebro,Sweden Online Publication Date: 01 January 2008
To cite this Article Gottvall, Tomas and Filbey, Derek(2008)'Alloimmunization in pregnancy during the years 1992-2005 in the central
west region of Sweden',Acta Obstetricia et Gynecologica Scandinavica,87:8,843 — 848
To link to this Article: DOI: 10.1080/00016340802268880 URL: http://dx.doi.org/10.1080/00016340802268880
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Acta Obstetricia et Gynecologica. 2008; 87: 843Á848
Alloimmunization in pregnancy during the years 1992 2005 in the central west region of Sweden
TOMAS GOTTVALL1 & DEREK FILBEY2
¨ Department of Obstetrics and Gynecology, University Hospital, Orebro, Sweden, 2Department of Transfusion Medicine, ¨ rebro, SwedenUniversity Hospital, O
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Abstract Objectives. To study the incidence of red cell immunization and to evaluate the use of low-risk invasive procedures in the management of alloimmunized during pregnancy. Design. A 14-year retrospective study of all immunized mothers and their newborns. Population. All reportedalloimmunizations between the years 1992 and 2005 in our catchment area were examined. Methods. Background factors, maternal antibody classification, antibody titers, anti-D quantitation, procedures and maternal treatments instituted during pregnancy, fetal outcome and treatment of the newborn were evaluated. Results. There were 78,145 deliveries in the region. Alloimmunization during pregnancy wasdetected in 0.4% of all pregnancies, excluding ABO immunizations. A significant alloimmunization (titer level ]8) was detected in 0.16%. Anti-D immunizations were responsible for 60% of significant immunizations followed by anti-Fya in 10%, anti-c in 7% and antiK in 4%. Maternal plasma exchange and high-dose intravenous immunoglobulin were used as low-risk invasive treatments in 12 cases. Delivery wasin ]38 weeks in 93% of cases. Twenty-nine newborns were treated with exchange transfusions (ETs) after delivery, whereof 21/29 were due to anti-D, seven due to anti-c and anti-E and in one case anti-Fya. No deaths occurred due to severe alloimmunization. Conclusion. Anti-D still accounts for the most severe immunizations and for most of the cases where ET was necessary. Low-risk invasive...