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Query: UMLS:C0002871 (anemia)
 52,094 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In the 27 years, 1951--1977, 4315 babies weighing over 1 kg were born alive in Newcastle suffering from haemolytic disease of the newborn due to Rhesus isoimmunization; 197 (4.5 per cent) died within four weeks of delivery. Many babies with severe anaemia (cord Hb less than or equal to 8 g/dl) died of cerebral and/or pulmonary haemorrhage as a result of coagulation failure; others with hydrops had a chance of recovery with intensive care as long as there was no associated pulmonary hypoplasia. Hyaline membrane disease was no more common in babies with haemolytic disease than in other preterm babies of comparable birthweight, but incorrect assessment of gestational age prior to the induction of labour increased the risk of death from hyaline membrane disease. The introduction of closed chest cardiac massage virtually eliminated the risk of sudden unexpected death during exchange transfusion but there was still a 1.5 per cent chance of sudden circulatory collapse during exchange transfusion. Affected babies of less than 36 weeks gestation with respiratory problems face a substantial risk of kernicterus when the indirect serum bilirubin level exceeds 270 mumol/l (15 mg/100 ml). The establishment of a single referral centre for Rhesus isoimmunization reduced neonatal mortality in the area to half the national average in the early 1950's and this superiority was maintained throughout the next decade.
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PMID:Neonatal death in babies with rhesus isoimmunization. 11

Reference ranges for four hematological parameters--hemoglobin, hematocrit, white blood cell and platelet count--in each gestation were established from values for fetal blood samples obtained by cordocentesis from 72 pregnancies at 16-39 weeks gestation. These 72 fetuses turned out as normal or single malformations which should not affect fetal hematological values. Significant correlations were observed between hemoglobin, hematocrit and platelet counts and the number of weeks of gestation. No correlation was found between the white blood cell count and gestational age. Fetal anemia (hematocrit was below the lower limit of the 95% confidence interval) was found in 18 (7%) of all the fetuses that underwent cordocentesis, including nonimmune hydrops fetalis (8 cases), Rh isoimmunization (4 cases), twin-to-twin transfusion syndrome (3 cases), trisomy 18 (2 cases) and autoimmune thrombocytopenia (1 case). Of 26 hydropic fetuses, 8 (31%) were anemic. The prognosis of those fetuses depended on either the gestational age or the severity of the fetal anemia. Our results are useful in diagnosing fetal hematological disorders and to make decisions for fetal therapy.
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PMID:[Hematological values in fetal blood by cordocentesis]. 150 23

Plasma concentrations of atrial natriuretic factor were determined by radioimmunoassay in 16 human fetuses of between 19 and 38 weeks' gestation. Fifteen fetuses had varying degrees of anaemia as a result of Rh isoimmunisation, and one fetus was normal. Eight fetuses had ultrasonographic evidence of severe hydrops fetalis and an additional three fetuses had mild hydrops. Severely hydropic fetuses were more anaemic and immature than those with mild or no hydrops. Among fetuses from which samples were taken before in utero transfusion, concentrations of atrial natriuretic factor were higher in those with severe hydrops than in the other groups. An inverse relationship between the haemoglobin concentration and that of atrial natriuretic factor was found. In four fetuses in which severe hydrops resolved after intravascular transfusions in utero, there were significant decreases in plasma atrial natriuretic factor concentrations; in the fifth fetus the decrease was less pronounced. Raised concentrations of atrial natriuretic factor in fetuses with severe anaemia and hydrops may be the result of atrial natriuretic factor release induced by hypoxia.
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PMID:Atrial natriuretic factor in hydrops fetalis caused by Rh isoimmunisation. 169 2

Fetal blood samples were collected by cordocentesis from 82 pregnant women; 12 of whom had severe forms of Rh isoimmunization, while 70 comprised the control group. The mean hematocrit value in the group under investigation was 15.72 +/- 3.62% and indication of severe anemia. The pH value in this group was 7.31 +/- 0.06; pCO2 partial pressure 6.36 +/- 0.64; O2-2.65 +/- 0.89 kPa; bicarbonate 23.84 +/- 3.02 mMol/l: base excess was -2.72 +/- 2.66 mMol/l and saturation 28.66 +/- 15.56%. In the control group the following values were established: pH -7.386 +/- 0.05; partial pressure pCO2-4.980 +/- 0.31 kPa; O2--4.960 +/- 0.90 kPa; bicarbonate 21.560 +/- 0.27 mMol/l; base excess -2.30 +/- 0.90 mMol/l and saturation 67.23 +/- 11.60%. The pH, partial pressure O2 and saturation values were significantly lower, while partial pressure CO2 was significantly higher in the investigated group than in the control group. Bicarbonates and base excess do not change significantly in the presence of anemia. Fetal blood sampling carried out by means of cordocentesis is the most reliable method for assessment of the degree of fetal anemia. The values of acid base parameters and of blood gases are an indication of either respiratory, respiratory-metabolic or metabolic acidosis. The possibilities of prenatal diagnostics, undoubtedly, contribute to a significant reduction of perinatal mortality.
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PMID:The influence of anemia on respiratory gases and acid base parameters of the fetus. 191 18

Sinusoidal fetal heart rate pattern (FHR) is regarded by most authors as signifying a compromised fetus. In most cases, this is secondary to fetal anemia of different causes, usually Rh isoimmunization, more rarely to fetomaternal transfusion, bleeding vasa previa, placental chorioangioma, or traumatic amniocentesis. A case is described which to our knowledge is the first reported of a sinusoidal FHR pattern occurring in the relatively anemic donor twin in a case of the twin to twin transfusion syndrome. The importance of separate antepartum biophysical evaluation of each member of a twin pregnancy is emphasized.
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PMID:Sinusoidal fetal heart rate pattern associated with the twin to twin transfusion syndrome. 196 22

Twenty-nine hydropic infants were born in the Kandang Kerbau Hospital between 1980 and 1985, during which there were 131,658 deliveries, giving an incidence of 1 in 4,540 total births. Twenty-five of these cases were confirmed to be due to homozygous alpha thalassaemia. No case of fetal hydrops due to Rh isoimmunization was detected. The mean age of the mothers was 28.86 +/- 4.05 years (+/- SD). Eight patients had delivered 1 hydropic baby previously while 1 had a history of 2 babies with hydrops fetalis; 92% of the patients had been followed antenatally while 8% were first seen when they were admitted in labour; 25% of the patients had anaemia, 52% had polyhydramnios, 20% developed hypertension and 64% had bilateral lower limb oedema. None of the patients had concomitant hypertension, generalized oedema and proteinuria. In 4 cases of recurrent hydrops, serial ultrasound scans were performed from early pregnancy but ultrasonic features of hydrops fetalis were only seen from 27 weeks' gestation. Spontaneous labour occurred in 75% of patients at a mean of 32.3 +/- 3.3 weeks (+/- SD). All delivered vaginally and only 1 patient required abdominal decompression. Four patients required Caesarean section, 2 for failure to progress after induction of labour, 1 for major placenta praevia and the fourth for fetal distress; in the last case, diagnosis of hydrops fetalis was only made after delivery of the baby. All the babies in the series died within one hour of delivery. Homozygous alpha thalassaemia is the commonest cause of hydrops fetalis in Singapore and is an invariably fatal condition. It is associated with an increased incidence of maternal anaemia, polyhydramnios and prematurity.
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PMID:Bart's hydrops fetalis--clinical presentation and management--an analysis of 25 cases. 260 53

Erythroblastosis fetalis, hemolytic disease of the newborn, occurs when an isoimmunized mother produces antibodies that cross the placenta and cause hemolysis of fetal red blood cells. This hemolysis can be accompanied by severe anemia, ascites, pleural and pericardial effusions, congestive heart failure, and neurological damage with resultant perinatal mortality. Rh isoimmunization in pregnancy still occurs in spite of the advent of Rh immune globulin. This article describes the complex management and nursing implications associated with caring for the neonate with erythroblastosis fetalis.
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PMID:Care of the neonate with erythroblastosis fetalis. 314 28

The umbilical vein blood flow (UVBF) of the human fetus was studied by a method combining real-time and Doppler equipment in seven cases of maternal anemia, 20 cases of Rh isoimmunization and 19 cases of uterine bleeding during the third trimester of pregnancy. The last individual UVBF value before delivery had in Rh-isoimmunization a significant negative correlation with the cord hemoglobin level of the newborn infant (p less than 0.01), thus reflecting the severity of fetal hemolytic anemia. Severe isoimmunization (cord hemoglobin less than or equal to 140 g/l) was associated with a significantly higher UVBF, blood velocity in the umbilical vein and umbilical vein diameter than was observed in mild-moderate anemia. Maternal anemia seems to be causally associated with increased UVBF levels. Uterine bleeding, especially before the 34th week, often leads to increased UVBF in the fetus. The method used seems not only to be able to contribute to our knowledge of hemodynamic regulation in the human fetus, but also provides a new practical means of evaluating the severity of fetal affection in cases of Rh isoimmunization.
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PMID:Umbilical vein blood flow in the human fetus in cases of maternal and fetal anemia and uterine bleeding. 643 74

The management of (Rhesus) hemolytic disease of the fetus and newborn includes intrauterine transfusions to prevent the development of hydrops, treatment of the possible hyperbilirubinemia in the immediate postnatal period, and treatment of late anemia. Low levels of serum erythropoietin due to suppression of the bone marrow by multiple intrauterine transfusions is a suggested mechanism for this anemia. The aim of our study was to test whether recombinant human erythropoietin reduced the need for erythrocyte transfusions in these infants. Twenty infants with Rhesus isoimmunization were blindly randomized to treatment and control groups at the 2nd wk of life. The number of intrauterine and exchange transfusions and demographic data were similar in both groups. The infants in the treatment group received recombinant human erythropoietin, s.c. 200 U/kg of body weight three times a week for a period of 6 wk, whereas the infants in the control group received a placebo for the same period. In the treatment group, the mean number of erythrocyte transfusions was significantly lower than that of the control group (1.8 versus 4.2). The reticulocyte counts and Hb levels rose earlier in the treatment group. The platelet and neutrophil counts were similar in both groups throughout the study. This study demonstrates that recombinant human erythropoietin treatment decreases the need for erythrocyte transfusions in the late anemia of infants with Rh isoimmunization. Considering the risks of blood transfusions, this decrease in the donor exposure is worthwhile.
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PMID:Management of late anemia in Rhesus hemolytic disease: use of recombinant human erythropoietin (a pilot study). 872 37

A 28-year-old female patient presented with recurrent stillbirths between 28 and 30 weeks of gestation. At least one of the stillborn was hydropic at birth; alpha-thalassaemia and Rh isoimmunisation were ruled out. The patient was found to be suffering from congenital dyserythropoietic anaemia (CDA) type III, a rare form of congenital anaemia inherited as an autosomal dominant character in some families. It is tempting to speculate that at least the hydropic stillborn inherited the same disorder from the mother. CDA type III as a cause of hydrops fetalis has not been reported in the literature. The patient, who was transfusion-dependent, underwent splenectomy. Subsequently she did not need any transfusion for the last 6 months.
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PMID:A patient with congenital dyserythropoietic anaemia type III presenting with stillbirths. 949 May 63


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