IMMUNE FETAL HYDROPS - A SEVERE FORM OF RH ISOIMMUNIZATION
The prevalence of pregnancies with Rh isoimmunization decreased to about 0.6% of all cases due to anti-D immune globulin prophylaxis. Rh incompatibility or Rh isoimmunization pregnancies must be monitored by serial measurements of titers of maternal Rh antibodies and, if possible, by serial Doppler evaluation of peak systolic velocity in the middle cerebral artery. Nowadays, for the detection of fetal blood group and Rh we can use techniques which identify free fetal DNA in maternal plasma. We report the clinical case of a 35 years old woman, admitted to our clinic after not being able to perceive active fetal movement. She proved to be Rhesus negative, with a pathological obstetrical history and through ultrasound examination, the diagnosis of fetal hydrops was established. The presence of fetal hydrops determines the viability of a small percentage of about 11%, and the long-term prognosis of these children is burdened by the need of repeated transfusions to combat the inhibition of erythropoiesis. Our report highlights the importance of early diagnose and precise antibody monitoring, to provide proper management and prophylaxis.
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