Midtrimester Rh sensitization associated with circulating anticardiolipin antibodies and elevated maternal serum alpha-fetoprotein. A case report.
The incidence of antepartum Rh isoimmunization has been limited by third-trimester Rh immune globulin (RhIg) administration. Prophylactic failures are uncommon but can occur if sensitization takes place prior to the 28th week of gestation. We report a case of midtrimester Rh sensitization in an anticardiolipin antibody-positive primipara coincident with the discovery of an elevated maternal serum alpha-fetoprotein value, oligohydramnios and fetal growth retardation. This case suggests that fetal-maternal hemorrhage and subsequent sensitization may be facilitated by anticardiolipin antibody-induced placental damage. Prophylactic midtrimester RhIg administration might avoid sensitization in similar cases.
Silver
R K
RK
Division of Maternal-Fetal Medicine, Evanston Hospital, IL 60201, USA.
MacGregor
S N
SN
Sholl
J S
JS
Hobart
J M
JM
Neerhof
M G
MG
D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood*; D016736:Antiphospholipid Syndrome / Q000097:blood* / Q000150:complications; D005260:Female; D005313:Fetal Death; D005317:Fetal Growth Retardation / Q000209:etiology; D006801:Humans; D016104:Oligohydramnios / Q000209:etiology; D010922:Placenta Diseases / Q000150:complications; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011262:Pregnancy Trimester, Second; D012203:Rh Isoimmunization / Q000097:blood / Q000209:etiology*; D000509:alpha-Fetoproteins / Q000378:metabolism*
D017153:Antibodies, Anticardiolipin; D000509:alpha-Fetoproteins