Document Detail

Successful management of anti-Jra alloimmunization in pregnancy: a case report.
MedLine Citation:
PMID:  19923849     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hemolytic disease of the fetus/newborn due to Jr(a) immunization is very rare and considered to be mild, and only routine obstetrical care is recommended for pregnant women sensitized to the Jr(a) antigen. CASE REPORT: A 20-year-old nulliparous woman was referred to our hospital for perinatal management. Her indirect Coombs test was positive for anti-Jr(a) antibody (1:64). At 33 weeks' gestational age, we observed that fetal growth was mildly restricted and the peak systolic velocity of the fetal middle cerebral artery (PSV-MCA) was above the upper limit of the reference range (1.55 multiples of the median). Amniocentesis was also carried out and the DeltaOD450 value was in the lower mid-zone of the Liley curve. We continued to carefully observe the patient because we observed PSV-MCA values within 1.50-1.60 multiples of the median and no other findings of fetal anemia. She vaginally delivered a female infant weighing 2,136 g at 37 weeks' gestational age. The infant received treatment with both iron and recombinant erythropoietin without developing hyperbilirubinemia and blood transfusion. CONCLUSION: PSV-MCA should be monitored for the detection of fetal anemia, even in pregnant women sensitized to some antigens for which only routine obstetrical care is recommended.
Akio Masumoto; Hisashi Masuyama; Yumi Sumida; Tomonori Segawa; Yuji Hiramatsu
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-11-19
Journal Detail:
Title:  Gynecologic and obstetric investigation     Volume:  69     ISSN:  1423-002X     ISO Abbreviation:  Gynecol. Obstet. Invest.     Publication Date:  2010  
Date Detail:
Created Date:  2010-03-05     Completed Date:  2010-06-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7900587     Medline TA:  Gynecol Obstet Invest     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  81-3     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2009 S. Karger AG, Basel.
Department of Obstetrics and Gynecology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
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MeSH Terms
Blood Group Incompatibility / drug therapy,  pathology*,  ultrasonography
Erythroblastosis, Fetal / drug therapy,  pathology*,  ultrasonography
Erythropoietin / therapeutic use
Infant, Newborn
Iron / therapeutic use
Pregnancy Complications, Hematologic / pathology*,  ultrasonography
Rh Isoimmunization / drug therapy,  pathology*,  ultrasonography
Young Adult
Reg. No./Substance:
11096-26-7/Erythropoietin; 7439-89-6/Iron

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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