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Autoimmune Hemolytic Anaemias in Pregnancy: Experience in a Tertiary Care Hospital in South India

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Abstract

Background

Autoimmune hemolytic anaemia is very rare and there is limited data regarding their pregnancy outcomes. Hence we aimed to study the maternal and perinatal outcomes in pregnancies with autoimmune hemolytic anaemias (AIHA).

Methods

A retrospective descriptive study of pregnant women with AIHA, who delivered at SJMCH between January 2011 and January 2016 was carried out. Their antenatal and labour records were reviewed and demographic details noted.

The primary outcome measures studied were—the prevalence of AIHA, gestational age at delivery, antepartum, intrapartum and postpartum complications, mode of delivery and requirement of transfusion of blood and blood products. The secondary outcome measures studied included neonatal outcomes such as low birth weight, intrauterine growth restriction and need for intensive care. The data is presented as descriptive statistics, including means and percentage.

Results

The prevalence of AIHA was (18/12,420) 0.14%. The mean gestational age at delivery was 34 weeks; 100%, 77% and 50% had antenatal, intra partum or postpartum complications, respectively. 44% had preeclampsia, 38% intrauterine growth restriction and 16% preterm labour. 83% required additional drugs for treatment of AIHA.72% had vaginal delivery; 28% had caesarean delivery; 33% were transfused antenatally and 22% postnatally; 50% of the babies were preterm and required intensive care, 66% had low birth weight. There was no maternal mortality.

Conclusion

Multidisciplinary approach, early diagnosis and detection of autoimmune hemolytic anaemia and complications, good antenatal care, judicious transfusions and delivery at tertiary care centre are the keys to successful outcomes.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, St Johns Medical College and Hospital, Bengaluru, Karnataka, 560034, India

    Rao Preethi Venkatachala & C. N. Sheela

  2. Department of Medicine (Division of Haematology), St Johns Medical College and Hospital, Bengaluru, Karnataka, India

    Seetharam Anandram & Cecil R. Ross

Authors
  1. Rao Preethi Venkatachala
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  2. C. N. Sheela
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  3. Seetharam Anandram
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  4. Cecil R. Ross
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Correspondence to Rao Preethi Venkatachala.

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The study has been approved by the institutional ethics committee.

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As it was a retrospective study, waiver of consent was taken from the ethics committee.

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Rao Preethi Venkatachala is an Assistant Professor, Department of Obstetrics and Gynaecology, St Johns Medical College and Hospital, Bengaluru, Karnataka, India; C N Sheela is a Professor, Department of Obstetrics and Gynaecology, St Johns Medical College and Hospital, Bengaluru, Karnataka, India; Seetharam Anandram is an Assistant Professor, Department of Obstetrics and Gynaecology, St Johns Medical College and Hospital, Bengaluru, Karnataka, India; Cecil R Ross is a Professor, Department of Medicine (Division of Haematology) St Johns Medical College and Hospital, Bengaluru, Karnataka, India

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Venkatachala, R.P., Sheela, C.N., Anandram, S. et al. Autoimmune Hemolytic Anaemias in Pregnancy: Experience in a Tertiary Care Hospital in South India. J Obstet Gynecol India 71, 379–385 (2021). https://doi.org/10.1007/s13224-021-01443-8

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  • DOI: https://doi.org/10.1007/s13224-021-01443-8

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