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Pregnancy Outcome of Rh D Alloimmunized Pregnancies: A Tertiary Care Institute Experience of a Developing Country

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Abstract

Aim

To determine the socio-demographic characteristics and pregnancy outcome of Rh D alloimmunized women monitored with MCA PSV (middle cerebral artery peak systolic velocity).

Materials and Methods

In total, 363 Rh D alloimmunized women attended antenatal clinic or obstetric emergency between January 2006 and December 2014. MCA PSV was the screening method for detection of fetal anemia. Intrauterine blood transfusion (IUT) was given when MCA PSV was > 1.5 MOM. Totally, 162 women (164 fetuses) received 492 transfusions. Forty-eight women had fetal hydrops at presentation. Five women (three received IUT) were lost to follow-up. Pregnancy outcome of 358 women and socio-demographic characteristics of 363 women were analyzed.

Results

The perinatal mortality was 421, 66 and 87 per 1000 live births in hydrops group, non-hydrops IUT group and non-IUT group, respectively.

Conclusion

Rh alloimmunization is still a major cause of perinatal morbidity and mortality. The higher gravidity, previous history of pregnancy wastage, still births and hydrops increase the requirement of intrauterine transfusion. MCA PSV is an excellent tool for monitoring of Rh alloimmunized pregnancies to detect fetal anemia. Early detection and monitoring by MCA PSV improve its outcome.

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Author notes

  1. Rakhi Rai

    Present address: Department of Obstetrics & Gynecology, AIIMS, 3rd Floor, Teaching Block, New Delhi, India

Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India

    Subhas Chandra Saha, Rakhi Rai & Rashmi Bagga

  2. Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India

    Ashish Jain

  3. Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India

    Kanya Mukhopadhyay & Praveen Kumar

Authors
  1. Subhas Chandra Saha
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  2. Rakhi Rai
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Correspondence to Rakhi Rai.

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Dr. Subhas Chandra Saha is a Professor MD, Departments of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India; Dr. Rakhi Rai is an Ex Assistant Professor MS, Departments of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India; Dr. Rashmi Bagga is a Professor MD, Departments of Obstetrics and Gynaecology, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, 160012, India; Dr. Ashish Jain is an Additional Professor MD, Department of Transfusion Medicine, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India; Dr. Kanya Mukhopadhyay is a Professor MD, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India; Dr. Praveen Kumar is a Professor MD, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India

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Saha, S.C., Rai, R., Bagga, R. et al. Pregnancy Outcome of Rh D Alloimmunized Pregnancies: A Tertiary Care Institute Experience of a Developing Country. J Obstet Gynecol India 71, 583–590 (2021). https://doi.org/10.1007/s13224-021-01455-4

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  • DOI: https://doi.org/10.1007/s13224-021-01455-4

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