| 1. |
- Adolfsson, Annsofie, 1960-, et al.
(författare)
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Miscarriage : women’s experience and its cumulative incidence
- 2006
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many women experience miscarriage every year. Every fourth woman who has given birth reports that she has previous experience of miscarriage. In a study of all women in the Swedish Medical Birth Register 1983-2003, we found that the number of cases of self reported miscarriage had increased in Sweden during this 21 year period. This increase can be explained by the introduction of sensitive pregnancy tests around 1990, as well as an increase in the mean age of the mothers, by approximately 3 years, during the observation period. The risk of miscarriage is 13% with the first child. With subsequent pregnancies, the risk of miscarriage is 8%, 6% and 4% with the second, third and fourth child, respectively.Thirteen of these women who had suffered a recent miscarriage were interviewed four months later, and their feelings of guilt and emptiness were explored. Their experience was that they wanted their questions to be answered, and that they wanted others to treat them as the mothers to be that they felt themselves to be. They also experienced the need for time to grieve their loss.Measurement of grief by means of the Perinatal Grief Scale (PGS) is used in research but has also been proposed for clinical use. We have translated this psychological instrument to Swedish, back-translated and tested it in a small pilot study. In a randomized controlled study, women with early miscarriage were allocated, either to a structured visit (study group) or a regular visit (control group) to a midwife. The structured visit was conducted according to the Swanson caring theory. We could conclude that the structured visit had no significant effect on grief compared to the regular visit, as measured using the PGS. However, women with the sub-diagnosis missed abortion have significantly more grief four months after early miscarriage, regardless of visit type.We also performed a content analysis of the tape-recorded structured follow-up visit. The code-key used was Bonanno and Kaltman’s general grief categorization. Women’s expression of grief after miscarriage was found to be very similar to the grief experienced following the death of a relative. Furthermore, the grief was found to be independent of number of children, women’s age, or earlier experience of miscarriage.Conclusions: Every fourth woman who gives birth reports that she has also experienced early miscarriage. The experience of these women is that they have suffered a substantial loss and their reaction is grief similar to that experienced following the death of a relative.
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| 2. |
- Aittomaki, K, et al.
(författare)
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Genetics and assisted reproduction technology
- 2005
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Ingår i: Acta Obstet Gynecol Scand. - : Wiley. ; 84:5, s. 463-473
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Tidskriftsartikel (refereegranskat)abstract
- In the past 20 years, a significant improvement has been shown in the treatment for infertility in both women and men through the development of in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). Only donated sperm could be previously used for treatment; now oocytes can also be donated. Furthermore, the combination of IVF and ICSI with advanced genetic methods has made preimplantation genetic diagnosis possible for many genetic conditions. These methods enable genetic testing of the early human embryo by using only a single cell, one blastomere biopsied from the embryo, as the sample from which the diagnosis of many chromosome rearrangements and other inherited diseases can be made. It has also been established that a considerable proportion of infertility is caused by genetic defects, which have several implications for infertility treatment. The purpose of this review is to give a concise introduction on how genetics is involved in assisted reproduction technology to specialists who may not be working in this particular field of gynecology, but who would need some knowledge of this for proper care of their patients.
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| 3. |
- Aittomaki, K, et al.
(författare)
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Safety issues in assisted reproduction technology: should ICSI patients have genetic testing before treatment? A practical proposition to help patient information
- 2004
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Ingår i: Hum Reprod. - : Oxford University Press (OUP). ; 19:3, s. 472-476
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Tidskriftsartikel (refereegranskat)abstract
- ICSI is a highly efficient treatment of male factor infertility and therefore increasingly used to treat infertile men successfully. However, when used to treat patients with a genetic cause for their infertility, there may be an increased risk for the offspring. Chromosome aberrations, Y chromosome microdeletions and CFTR (cystic fibrosis transmembrane conductance regulator) mutations alone may explain up to 25% of azoospermia and severe oligozoospermia. These genetic defects could be identified before treatment, in which case informed decisions could be made by the couple to be treated concerning the treatment, prenatal testing or preimplantation genetic diagnosis. Therefore, we propose that men with very low sperm counts (<5 x 10(6)/ml) considering ICSI should always be informed of the possibility of genetic testing. The information should include a precise statement of the implications of the results for the patient, his family and his offspring, and reassurance that a decision to test or not to test, or the subsequent test results will not be used as a reason for withholding treatment. Testing should always remain voluntary, and the couples themselves should decide whether or not they choose to be tested. If an abnormality is identified, patients should be referred to specialist genetic counselling.
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| 4. |
- Bergh, Christina, 1953, et al.
(författare)
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Attitudes towards and management of single embryo transfer among Nordic IVF doctors
- 2007
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 86:10, s. 1222-1230
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Tidskriftsartikel (refereegranskat)abstract
- Background. The objective of this study was to investigate the attitudes towards and management of single embryo transfer (SET) among Nordic in vitro fertilisation (IVF) doctors, and to present the rate of SET and multiple pregnancies in the different countries. Methods. A questionnaire was sent to all IVF doctors in the Nordic countries (n=198, 78.5% responded). Pregnancy rates, SET and multiple births rates were extracted from registries. Main outcome measure was attitudes and management of SET. Results. Almost all doctors thought that a twin pregnancy compared unfavourably to a singleton. A twin rate >10% was acceptable for 5% of Swedish doctors. Corresponding figures for Finnish, Danish and Norwegian doctors were 21, 35 and 35%, respectively. For a woman <36 years, performing her first cycle and with two good quality embryos, almost all doctors would recommend SET. For a woman =36 years in a similar situation, SET would be recommended only in Sweden and Finland. The pregnancy rate per embryo transfer (ET), the SET rate 2003, the multiple birth rate, and the estimated SET rate 2004 were 33.3, 21.5, 22.7 and 25% (Denmark), 31.3, 43.4, 14 and 51% (Finland), 40.5, 10.5, 26.5 and 16% (Iceland), 30.6, 18, 25.2 and 26% (Norway), and 35.3, 55.1, 11.8 and 71% (Sweden). Conclusions. The SET and multiple birth rates reflect the attitudes of Nordic IVF doctors to SET and multiple births well. When introducing SET, the attitude of the IVF doctor seems to be important. © 2007 Taylor & Francis.
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| 5. |
- Blomberg, Marie, 1963-, et al.
(författare)
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Congenital malformations in the southeast of Sweden : a registry study with validation
- 2000
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Ingår i: Acta Paediatrica. - : Wiley. - 0803-5253 .- 1651-2227. ; 89:10, s. 1238-1243
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Tidskriftsartikel (refereegranskat)abstract
- A study was made of the occurrence of congenital malformations in the southeast region of Sweden, utilizing all available relevant health registries. Östergötland county had been pinpointed in a routine surveillance as having an increased malformation risk. Various validations of the register data were undertaken and different types of errors were detected. An increased risk was seen, in Östergötland county compared to the reference counties, for specific types of malformations: preauricular appendices, pylorostenosis, uterine/vaginal malformations, foot deformities, limb reduction defects and cardiovascular malformations. Variable classification or registration artefacts explained the excess among the first four conditions. Limb reduction defects were also mis-coded, but the increased risk in Östergötland county may persist.Conclusion: There is an increased risk of major cardiovascular malformations in Östergötland county compared to the reference counties that also shows an uneven distribution within the county.
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| 6. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Chlorination byproducts and nitrate in drinking water and risk for congenital cardiac defects
- 2002
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Ingår i: Environmental Research. - : Elsevier BV. - 1096-0953 .- 0013-9351. ; 89:2, s. 124-130
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Tidskriftsartikel (refereegranskat)abstract
- Drinking water disinfection byproducts have been associated with an increased risk for congenital defects including cardiac defects. Using Swedish health registers linked to information on municipal drinking water composition, individual data on drinking water characteristics were obtained for 58,669 women. Among the infants born, 753 had a cardiac defect. The risk for a cardiac defect was determined for ground water versus surface water, for different chlorination procedures, and for trihalomethane and nitrate concentrations. Ground water was associated with an increased risk for cardiac defect when crude rates were analyzed but after suitable adjustments this excess rate was found to be determined by chlorination procedures including chlorine dioxide. Chlorine dioxide appears itself as an independent risk factor for cardiac defects (adjusted odds ratio 1.61 (95% CI 1.00-2.59)). The risk for cardiac defects increased with increasing trihalomethane concentrations (P = 0.0005). There was an indicated but statistically nonsignificant excess risk associated with nitrate concentration. The individual risk for congenital cardiac defect caused by chlorine dioxide and trihalomethanes is small but as a large population is exposed to public drinking water, the attributable risk for cardiac defects may not be negligible. (C) 2002 Elsevier Science (USA).
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| 7. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Detection of fetal structural abnormalities by an 11-14-week ultrasound dating scan in an unselected Swedish population
- 2006
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 85:8, s. 912-915
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Tidskriftsartikel (refereegranskat)abstract
- Background. To determine the detection rate of fetal structural abnormalities by a routine 11-14-week ultrasound scan for dating in an unselected pregnant population. Methods. A prospective observational cohort study of 2,708 unselected pregnant women attending an abdominal ultrasound examination at 11-14 weeks gestation. The number of major fetal structural abnormalities diagnosed after birth was obtained from a computerized database at the same unit. Results. Out of 2,708 pregnant women, 89 (3.3%) were found to have a missed abortion at the time of the ultrasound scan and 33 (1.2%) were diagnosed as twins. Thirteen major structural abnormalities were detected, three cases of anencephaly (one case also had a spina bifida), one case with hydranencephaly, one fetus with Dandy-Walker syndrome, two cases with gastroschisis, one case with a bilateral hydronephrosis, one case with a generalized hydrops, one fetus with multiple malformations, and three cystic hygromas. An additional 19 major structural defects were detected at birth. Four cases of neural tube defects and nine fetuses with congenital heart defects were diagnosed. The antenatal ultrasound detection rate was 40.6% (13/32). Nine patients had a nuchal translucency greater than 3.0 mm (excluding cystic hygromas), two of them had chromosomal abnormalities (trisomy 21 and trisomy 18). Conclusions. Fetal structural abnormalities were detected in 41% (95%CI = 24-59) of the cases in an unselected pregnant population at a routine 11-14-week ultrasound scan for dating purpose. Two out of nine fetuses with a nuchal translucency greater than 3.0 mm had a chromosomal abnormality. © 2006 Taylor & Francis.
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| 8. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Geographic variations in possible risk factors for severe cardiac malformations
- 2002
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Ingår i: Acta Pædiatrica. - : Wiley. - 1651-2227 .- 0803-5253. ; 91:2, s. 222-228
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate various putative risk factors in a county in Sweden, described as having a 28% increased prevalence of cardiovascular malformations, and to compare them with the risk factors in two reference counties. Women giving birth in the studied counties differed in age and parity distribution, smoking, and educational level but these differences could not explain the increased risk of cardiovascular malformations in the county, since after stratification for these variables, the risk, estimate did not change substantially. A number of potential risk factors were studied in a case/control design: spontaneous abortions, involuntary childlessness, maternal disease, body mass index, medical drug use, alcohol use, parental employment, paternal age, and urban/rural residency. No single factor could be attributed to the increased rate, with the exception of living in a rural district, Nearly all risk factors, however, were stronger in the county studied than those in the reference counties (0.02 > p > 0.01). Conclusion: The only single putative risk factor that could have contributed to the increased risk for cardiac defects described in the county Studied was maternal residency in a rural district. Notably, nearly all potential risk factors studied were stronger in the counts studied compared with those in the reference area. A conceivable explanation is that one or more unidentified factors related to rural residency could potentiate prevalent and weak teratogenic risk factors for cardiac defects.
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| 9. |
- Cedergren, Marie, 1963-, et al.
(författare)
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Risk factors for cardiovascular malformation - a study based on prospectively collected data
- 2002
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Ingår i: Scandinavian Journal of Work, Environment and Health. - : Scandinavian Journal of Work, Environment and Health. - 0355-3140 .- 1795-990X. ; 28:1, s. 12-17
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The aim of this study was to identify risk factors for cardiovascular malformation. Methods In a case-referent study prospectively collected data were obtained from original medical records. The study included 277 woman who had infants with a severe cardiac defect, and for each case two referents (medical records study) were included. Data on parental age, maternal reproductive history, disease in early pregnancy, reported maternal use of drugs and alcohol, smoking habits, parental occupation, and maternal body mass index (BMI) were extracted. When data were available from Swedish medical health registers, a comparison was made (register study) between all infants with cardiovascular defects (2208) and all infants born (175 768). Results Maternal diabetes mellitus was associated with an increased risk for cardiovascular malformation [odds ratio (OR) 2.38, 95% confidence interval (95% CI) 1.36-4.15], as was a high BMI (> 29) (OR 1.46, 95%CI 1.12-1.90). A tendency towards an increased risk was found for involuntary childlessness, spontaneous abortion, thyroid drugs, and nonsteroid anti-inflammatory drugs. Conclusions Some known risk factors for cardiac defects (eg, maternal diabetes mellitus and the use of antiepileptics) could be identified. Other postulated risk factors could not be verified, for example, paternal age and parental occupation. The use of medicinal drugs seems not to be a major factor in the etiology of cardiac defects. It is possible, however, that there is an association with the use of nonsteroid anti-inflammatory drugs or drugs for thyroid disease. The relationship between a high BMI and cardiovascular malformation observed in this study may be explained by impaired maternal glucose tolerance.
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| 10. |
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| 11. |
- Hazekamp, J, et al.
(författare)
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Consideration of new strategies
- 2000
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Ingår i: Human Reproduction. - 0268-1161 .- 1460-2350. ; 15:6, s. 1217-1219
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Tidskriftsartikel (refereegranskat)abstract
- To maximize pregnancy rates, physicians who perform IVF, often transfer multiple embryos, which increases the multiple birth risk. Multiple birth infants are at significant risk for a number of adverse outcomes including preterm delivery, low birth weight, congenital malformations, fetal and infant deaths and long term morbidity and disability among survivors. Since the ultimate goal for an IVF treatment is the birth of a healthy infant, an important issue for all kinds of assisted reproductive technologies (ART) must be the reduction or elimination of multiple pregnancies. In this article, different strategies to avoid multiple births in ART are discussed.
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| 12. |
- Hildebrand, Eric, et al.
(författare)
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Comparison of first and second trimester ultrasound screening for fetal anomalies in the southeast region of Sweden
- 2010
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Ingår i: ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA. - : Informa Healthcare. - 0001-6349 .- 1600-0412. ; 89:11, s. 1412-1419
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To assess and compare the sensitivity for detecting fetal anomalies and chromosomal aberrations by routine ultrasound examination performed in the second trimester with results from an examination performed at 11-14 weeks gestation. Design. Observational study. Setting. Five centers in the southeast region of Sweden. Population. A total of 21,189 unselected pregnant women. Methods. The scan was performed at one center in the first trimester and at the remaining four centers in the second trimester. Outcome measures resulting from first trimester scanning were compared with those from the second trimester scanning. Main outcome measures. Detection rates of fetal structural anomalies and chromosomal aberrations. Results. At the first trimester scan 13% of all anomalies were detected, and at the second trimester scan 29% were detected. Lethal anomalies were detected at a high level at both times: 88% in the first, 92% in the second. The percentage of chromosomal aberrations discovered at the early scan was 71%, in the later 42%. The percentage of heart malformations detected was surprisingly low. Conclusion. The results showed the advantages of the later scan in discovering anomalies of the heart, urinary tract and CNS, and of the early scan in discovering chromosomal aberrations. Lethal malformations were detected at a high level in both groups, but detection of heart malformations needs improvement.
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| 13. |
- Immerstrand, Charlotte, et al.
(författare)
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Conjugated-polymer micro- and milliactuators for biological applications
- 2002
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Ingår i: MRS bulletin. - : Springer Science and Business Media LLC. - 0883-7694 .- 1938-1425. ; 27:6, s. 461-464
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Tidskriftsartikel (refereegranskat)abstract
- The development of new conjugated-polymer tools for the study of the biological realm, and for use in a clinical setting, is reviewed in this article. Conjugated-polymer actuators, based on the changes of volume of the active conjugated polymer during redox transformation, can be used in electrolytes employed in cell-culture media and in biological fluids such as blood, plasma, and urine. Actuators ranging in size from 10 μm to 100 μm suitable for building structures to manipulate single cells are produced with photolithographic techniques. Larger actuators may be used for the manipulation of blood vessels and biological tissue.
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| 14. |
- Jablonowska, Barbro, et al.
(författare)
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Analyses of human leukocyte antigen (HLA-DRB1 and HLA-G alleles in couples with unexplained recurrent spontaneous abortion : typing by using the Polymerase Chain Reaction method
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Annan publikation (övrigt vetenskapligt/konstnärligt)abstract
- Background: Increased parental Human Leukocyte Antigen (HLA) sharing has been repmted in couples witb history of unexplained recurrent spontaneous abmtion (RSA). Parental HLA sharing increases the risk of feto-matemal histo-compatibility and potentially affects maternal alia-recognition of the fetus. HLA-G is expressed on trophoblast and is expected to play an important role during placental and fetal development. The aim of the present study was to investigate the compatibility of HLA-DRB1 alleles in the couples with unexplained RSA and to investigate the frequency of HLA-DRB1 alleles and HLA-G alleles in these couples compared with fertile controls.Methods: The frequency of HLA-DRB1 alleles in 36 couples with unexplained recurrent spontaneous abmtion, and the compatibility of HLA-DRB1 alleles between patient couples were studied using a polymerase chain reaction-sequence specific primers (PCR- SSP) method. The frequency of HLA-G alleles in 35 couples were studied using a polymerase chain reaction - single nuclotide polymorphism (PCR-SNP). As controls we used 40 fertile couples who were typed for HLA-DRB1 and HLA-G alleles.Results: There were no significant differences for HLA-DRB1 and HLA-G allele frequencies in RSA couples compared with fertile controls. There was no significant HLA-DRB1 allele sharing between the RSA couples and fertile controls.Conclusions: There is no higher HLA-DRB1 allele sharing in couples with unexplained RSA than in fettile couples. The association on allelic level between RSA and HLA-G gene was not supported by our data.
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| 15. |
- Jablonowska, Barbara, 1948-, et al.
(författare)
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Blocking antibodies in blood from patients with recurrent spontaneous abortion in relation to pregnancy outcome and intravenous immunoglobulin treatment
- 2001
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Ingår i: American Journal of Reproductive Immunology. - : Wiley. - 1046-7408 .- 1600-0897 .- 8755-8920. ; 45:4, s. 226-231
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Tidskriftsartikel (refereegranskat)abstract
- PROBLEM: To study whether the occurrence of mixed lymphocyte culture (MLC) blocking antibodies is associated with pregnancy outcome in women with unexplained recurrent spontaneous abortion (RSA) and the in vivo effect of intravenous immunoglobulin (IVIG) treatment on MLC blocking effect.METHOD OF STUDY: Blood samples from 41 RSA patients were obtained before and after pregnancy, and blocking antibodies were estimated by one-way MLC assay. The patients received IVIG or placebo (saline) during pregnancy. Additionally, pre-pregnancy blood samples from 31 RSA women and 10 controls were obtained.RESULTS: We found no correlation between blocking antibodies before pregnancy and the pregnancy outcome. The occurrence of blocking antibodies was not affected by pregnancy or IVIG treatment.CONCLUSIONS: Blocking antibodies have no predictive value for the pregnancy outcome in RSA patients, and their production seems not to be affected by IVIG.
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| 16. |
- Jablonowska, Barbara, 1948-, et al.
(författare)
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Prevention of recurrent spontaneous abortion by intravenous immunoglobulin : a double-blind placebo-controlled study
- 1999
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Ingår i: Human Reproduction. - : Oxford University Press (OUP). - 0268-1161 .- 1460-2350. ; 14:3, s. 838-841
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to evaluate the therapeutic efficacy of intravenous immunoglobulin (IVIG) in the prevention of recurrent spontaneous abortion (RSA). In a double-blind, randomized, placebo-controlled study, 41 women with a history of unexplained recurrent spontaneous abortion were treated with IVIG or saline infusions during pregnancy. The birth of a child was considered a successful outcome. The overall success rate was 77% in the IVIG group compared with 79% in the placebo group. For women with primary RSA the success rates were 82 (IVIG) and 89% (placebo), and for women with secondary RSA the rates were 73 (IVIG) and 70% (placebo). We found no statistically significant difference in treatment results between IVIG and placebo.
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| 17. |
- Jablonowska, Barbara, 1948-, et al.
(författare)
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T and B lymphocyte subsets in patients with unexplained recurrent spontaneous abortion : IVIG versus placebo treatment
- 2002
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Ingår i: American Journal of Reproductive Immunology. - : Wiley. - 1046-7408 .- 1600-0897. ; 48:5, s. 312-318
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Tidskriftsartikel (refereegranskat)abstract
- Jablonowska B, Palfi M, Matthiesen L, Selbing A, Kjellberg S, Ernerudh J. T and B Lymphocyte subsets in patients with unexplained recurrent spontaneous abortion: IVIG versus placebo treatment. AJRI 2002; 48:312–318 © Blackwell Munksgaard, 2002PROBLEM: To investigate circulating lymphocyte subsets in women with recurrent spontaneous abortion (RSA) in relation to pregnancy outcome and to treatment with intravenous immunoglobulin (IVIG).METHOD OF STUDY: Forty-one women with a history of unexplained RSA were examined during first trimester of pregnancy before IVIG or placebo treatment and after pregnancy. The results were compared with five healthy, non-pregnant women and five women in the first trimester of normal pregnancy. Circulating lymphocyte subsets with focus on T-cell subpopulations were determined by flow cytometry.RESULTS: The proportions of human leukocyte antigen (HLA)-DR positive T cells (CD3+ HLA-DR+), T-killer/effector cells (CD8+ S6F1+) and B cells (CD19+) were increased, whereas the proportion of T-suppressor/inducer cells (CD4+ CD45RA+) was decreased during first trimester pregnancy of RSA women compared with pregnant normal controls. T and B lymphocyte subsets did not correlate with pregnancy outcome on either IVIG or placebo group.CONCLUSIONS: In RSA patients, the immune system seems to be activated in contrast to the suppression noted in normal pregnancy.
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| 18. |
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| 19. |
- Palfi, Miodrag, 1954-, et al.
(författare)
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A case of severe Rh (D) alloimmunization treated by intensive plasma exchange and high-dose intravenous immunoglobulin
- 2006
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Ingår i: Transfusion and apheresis science. - : Elsevier BV. - 1473-0502 .- 1878-1683. ; 35:2, s. 131-136
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Tidskriftsartikel (refereegranskat)abstract
- Background: In extremely severe Rh (D) alloimmunization, during pregnancy, early diagnosis and treatment is essential to avoid hydrops fetalis. Intrauterine transfusion (IUT) is of utmost importance in the prevention of fetal anemia but it is usually feasible only after 20 weeks of pregnancy. Therefore, additional treatment options in early pregnancy are needed. Study design and methods: A 27-year-old severely D + C immunized woman was admitted at 8 weeks of gestation in her fifth pregnancy with an extremely high concentration of anti-D. Her first pregnancy was uneventful but resulted in D + C alloimmunization. The next two pregnancies were unsuccessful, because of hydrops fetalis resulting in fetal death in pregnancy week 20 and 24, respectively, despite treatment with high-dose intravenous immunoglobulin (IVIG) and IUT treatment. A fourth pregnancy was terminated with legal abortion. The patient was eager and persistent to accomplish a successful pregnancy. Therefore, a combination of treatments consisting of plasma exchange (PE) three times/week and IVIG 100 g/week was started in pregnancy week 12. PE was performed 53 times and totally 159 L of plasma was exchanged. Results: The anti-D concentration was 12 μg/mL (IAT titer 2000) before start of treatment by PE and IVIG in pregnancy week 12. The concentration of anti-D was gradually reduced to approximately 3 μg/mL after only two weeks of treatment and was maintained at that level until pregnancy week 22. In pregnancy week 26 and 27, signs of hydrops were detected by ultrasonography and IUT were performed at each occasion. Sectio was inevitable at pregnancy week 28 + 1 and a male baby was born: Hb 58 g/L (cord sample) and 68 g/L (venous sample), weight 1385 g, Apgar score = 4-5-7, Bilirubin 56-150 mmol/L (4 h). Exchange transfusion was performed on day two and day five. Phototherapy was also implemented for eight days. The newborn's recovery thereafter was uneventful and complete. Conclusion: A combination of PE and IVIG may be an efficient treatment possible to start in early pregnancy in patients with extremely severe Rh (D) alloimmunization, with a history of hydrops fetalis in previous pregnancies. © 2006 Elsevier Ltd. All rights reserved.
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| 20. |
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