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  • Review Article08-13-2009

    Alloimmunization

    Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):311-319

    Abstract

    Review Article

    Alloimmunization

    Revista Brasileira de Ginecologia e Obstetrícia. 2009;31(6):311-319

    DOI 10.1590/S0100-72032009000600008

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    Alloimmunization is the formation of antibodies when there is an exposition of the individual to non-self antigens, as it occurs, for example, in the transfusion of incompatible blood and pregnancies, in whom the fetus express in its sanguineous cells antigens exclusively of paternal origin. This article is restricted to the alloimmunization against erythrocytes antigens in obstetric patients. Almost all the anti-erythrocytes antibodies can be fit in one of the 29 systems of already recognized sanguineous groups, being more implied in the hemolytic disease of the newborn anti-D, anti-c and anti-Kell, followed by anti-C, anti-E, anti e, anti-Fyª and anti-Jkª. The research of irregular antibodies, to permit the diagnosis of alloimmunizated people, and the modern genetic techniques have better characterized these patients for the prophylaxis and prenatal segment. The traditional accompaniment of the gestations of risk for hemolytic disease of the newborn, with the spectral analysis of the amniotic liquid and the intraperitoneal transfusion, has being quickly substituted for the Doppler ultrasound evaluation in the middle cerebral artery, the intravascular transfusion guided for ultrasonography in real time, beyond improvements in the materials and the quality of the blood, that in set, have raised the survival of the attempting fetus. Doubtlessly, the correct application of the prophylaxis with use of anti-D is successful with potential to reduce the alloimmunization cases.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
  • Original Article08-04-2004

    Why do we waste anti-D immunoglobulin in early miscarriage?

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(5):363-367

    Abstract

    Original Article

    Why do we waste anti-D immunoglobulin in early miscarriage?

    Revista Brasileira de Ginecologia e Obstetrícia. 2004;26(5):363-367

    DOI 10.1590/S0100-72032004000500004

    Views66

    OBJECTIVE: evaluation of fetomaternal hemorrhage (FMH) in patients who would need Rh alloimmunization with anti-D immunoglobulin (300 mug) prophylaxis after early miscarriage. METHOD: we included in the study Rh (D) negative blood group patients with positive or unknown Rh (D) partners, who had had a miscarriage up to 12 weeks of gestation, and had been admitted to hospital for uterine curettage. After this procedure 5 ml of venous blood was collected from the patients and the rosette test was applied to screen which patients would need quantitative determination of fetal blood transferred to the maternal circulation, by the Kleihauer-Betke test (K-B). RESULTS: out of 26 patients evaluated the rosette test was positive in one , who showed an FMH of 1.5 ml in the K-B test. CONCLUSIONS: the dose of anti-D immunoglobulin used in cases of miscarriage up to 12 weeks of gestation should be substantially reduced. The availability of preparations of 50 mug is recommended, for a more inexpensive and rational treatment.

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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