Document Detail


Fetal plasma erythropoietin concentration in red blood cell-isoimmunized pregnancies.
MedLine Citation:
PMID:  1442979     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The aim of this study was to investigate the relationship between fetal anemia, plasma erythropoietin concentration, and erythroblastosis in red blood cell-isoimmunized pregnancies. STUDY DESIGN: Fetal plasma erythropoietin concentration in umbilical venous blood samples from 68 red blood cell-isoimmunized pregnancies at 18 to 35 weeks' gestation was measured. Measurements were compared with the appropriate reference range with gestation, and associations with blood pH, erythroblast count, and hemoglobin concentration were examined. RESULTS: The mean fetal plasma erythropoietin concentration and erythroblast count in red blood cell-isoimmunized pregnancies were significantly increased only in severe fetal anemia (hemoglobin deficit > 7 gm/dl). Furthermore, some severely anemic fetuses were hydropic and acidemic. The degree of increase in plasma erythropoietin was significantly associated with both fetal acidemia and, more strongly, fetal erythroblastosis. CONCLUSION: These findings suggest that in fetuses from red blood cell-isoimmunized pregnancies the ability to prevent tissue hypoxia is present until anemia becomes severe, presumably by an increase in cardiac output and tissue perfusion. In severe anemia tissue hypoxia occurs, and the data indicate that fetuses respond by increasing erythropoietin production from at least 20 weeks' gestation. Furthermore, more accurate assessment of tissue oxygenation may be obtained by measuring the erythroblast count rather than the blood pH.
Authors:
B Thilaganathan; D R Salvesen; A Abbas; R M Ireland; K H Nicolaides
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American journal of obstetrics and gynecology     Volume:  167     ISSN:  0002-9378     ISO Abbreviation:  Am. J. Obstet. Gynecol.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-18     Completed Date:  1992-12-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370476     Medline TA:  Am J Obstet Gynecol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1292-7     Citation Subset:  AIM; IM    
Affiliation:
Harris Birthright Research Centre for Fetal Medicine, King's College School of Medicine, London, England.
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MeSH Terms
Descriptor/Qualifier:
Anemia / blood
Cordocentesis
Erythroblastosis, Fetal / blood
Erythrocytes / immunology*
Erythropoietin / blood*
Female
Fetal Blood / metabolism*
Fetal Diseases / blood
Humans
Infant, Newborn
Pregnancy
Pregnancy Complications, Hematologic / blood*
Rh Isoimmunization / blood*
Chemical
Reg. No./Substance:
11096-26-7/Erythropoietin

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