Antecedents to and outcomes of Rh(D) isoimmunization: Mater Mothers Hospital, Brisbane, 1988-1995.
We analyzed the antecedents and outcomes of Rh(D) isoimmunization in a local population. Forty-two Rh(D) isoimmunized women attending Mater Mothers Hospital for antenatal care were identified through the Mater Hospital Blood Bank database; their records were reviewed for variables including sensitizing events, obstetric interventions and pregnancy outcomes. In this group, 74% of women became sensitized despite receiving anti-D immune globulin, 17% did not receive anti-D appropriately and the other failed to attend for treatment of bleeding in pregnancy. Antenatal sensitization was implicated in 6 women (14%) and potentially responsible for isoimmunization in another 18. Over half of the 80 viable pregnancies in this study group required some form of obstetric intervention. Thirty pregnancies required amniocentesis and 1 in 3 babies underwent either intrauterine or exchange transfusion. Three fetal deaths occurred as a result of severe disease. This study offers information highlighting circumstances in which immunoprophylaxis guidelines have failed to impart protection against Rh(D) sensitization and the consequences of such failures.
Portmann
C
C
Division of Obstetrics and Gynaecology, Mater Mothers Hospital, Queensland.
Ludlow
J
J
Joyce
A
A
Chan
F Y
FY
D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011256:Pregnancy Outcome; D011793:Queensland; D012189:Retrospective Studies; D012203:Rh Isoimmunization