RESUMO
OBJECTIVE: To report our experience in preventing RhD maternal isoimmunization by using anti-D gamma globulin among Rh-negative women. MATERIAL AND METHODS: Between 1982 and 1995, immunologic and hematologic data were collected from all Rh-negative women seen at Mexico's National Perinatology Institute. Women at risk of Rh isoimmunization were given a prophylactic dose of 150 micrograms of anti-D gamma globulin. RESULTS: A total of 4,857 Rh-negative women were seen during the study period (4.85% of the total population of women seen at the Institute), 629 (13.0%) of whom developed RhD isoimmunization; 542 (86.2%) of these women were already isoimmunized when first seen at our Institute. Twenty-two women (3.5%) developed isoimmunization even after receiving a proper dose of anti-D gamma globulin. Prophylaxis was given to 2,605 women (53.6%); 2,039 received a single dose, and 475 two doses. Prophylaxis failed in 22 cases; four were women with multiple pregnancy and 18 developed obstetric pathologic conditions. CONCLUSIONS: The use of anti-D gamma globulin resulted in a reduction of maternal Rh isoimmunization to less than one case per 1,000 women. Failures to prevent isoimmunization were associated to additional obstetric conditions and to lack of adherence to prevention guidelines.
Assuntos
Imunização Passiva/métodos , Isoimunização Rh/prevenção & controle , gama-Globulinas/imunologia , Feminino , HumanosRESUMO
OBJECTIVE: To describe the changes during the period of transition of the TNF-alpha and IL-1 beta in newborn healthy, under effect of deliver. MATERIAL AND METHODS: They were selected randomly at term newborn, with low perinatal risk. We quantified the plasmatic concentrations of TNF-alpha and IL-1 beta at birth, one hour and 24 hours of life. RESULTS: We included 110 newborn. The concentrations of TNF-alpha and IL-1 beta quantified to the birth, at the time of life and to the 24 hours of life; were of 7.4, 8.7 and 9.3 pg/mL and of 1.1, 1.3 and 0.7 pg/mL, respectively. In the TNF-alpha, was significant difference to the birth (12.9 versus 4.4 pg/mL) and one hour of life (14.7 vs 5.6 pg/mL), with more elevated values in neonates born by vaginal delivery (p < 0.01). There was not the same effect for the IL-1 beta. There was not statistical influence in relation to sex, birth weight when or gestational age. CONCLUSIONS: The TNF-alpha, but not it IL-1 beta, it presented statistical changes associate to the delivery.
Assuntos
Parto Obstétrico , Interleucina-1/sangue , Fator de Necrose Tumoral alfa/análise , Fatores Etários , Biomarcadores/sangue , Humanos , Recém-NascidoRESUMO
The object of this study was to evaluate the changes in fibrinolysis and clotting inhibitors in patients with preeclampsia and to describe the connection between preeclampsia and blood pressure values. Two groups of pregnant women were prospectively studied at delivery: group 1 women without preeclampsia and group 2 patients with preeclampsia. The variables that were registered are: diastolic blood pressure (DBP), systolic blood pressure (SBP), mean blood pressure (MBP), hemoglobin (Hb), platelet count (Plt), lupus like inhibitor, anticardiolipin antibodies (ACA), antinuclear antibodies (ANA), fibronectina, D dimer, protein S (PS), protein C (PC) and vo Willebrand factor (vWF). 62 pregnant women were included. The patients of group 2 presented high values of Hb (p 0.01), fibronectin (p 0.0001), D-dimer (p 0.01) and lower PC (p 0.04). We found an association between fibronectin and higher values of SBP, DBP, MBP and Hb (p 0.0007) versus lower values of VFW and PC (p 0.002). The low values of total PS were associated with high D-dimer and SBP results (p 0.04 and 0.002 respectively). All patients were ACA/ANA negative. In preclampsia there is a increased hemoconcentration and drop in clotting inhibitors (PC), without fibrinolytic compensatory response (lower D-dimer) and remarked vasopressive effect (hig fibronectin). This changes depend on the stratification of blood pressure. Th SBP and MBP values depend on the haemodynamic changes (Hb, fibronectin), while the increase in DBP expresses a non compensated thrombophilic state.
Assuntos
Pré-Eclâmpsia/complicações , Trombofilia/complicações , Pressão Sanguínea , Estudos Transversais , Feminino , Hemodinâmica , Humanos , Contagem de Plaquetas , Pré-Eclâmpsia/sangue , Gravidez , Resultado da Gravidez , Estudos Prospectivos , Trombofilia/sangueRESUMO
Included in this study are the results of the tests done with irregular anti-erythrocytic antibodies outside of the ABO system of women in reproductive stage. In 2,623 cases considered, 279 samples positive for the antibodies were found (10.6%). In 184 cases (65.9%), the antibodies were classified as "immune irregular". The most frequently found antibodies from this group were the anti-D (63.08%), followed by the anti-c (1.07%), the anti-Kell (0.72%), anti-C, anti-E and an anti-Rh system (0.36% for each one). In 52 cases (18.6%) there were irregular "natural" antibodies, predominantly the anti-Lewis (9.68%), followed by anti-P (5.02%), the anti-I (3.2%), an anti-M and an anti-N (0.36% each one). In 43 (15.4%) cases, we were not able to identify the specificity of the antibody found. We include a discussion and a comparison of the frequency of these antibodies in our population. Based on these data, we recommend the clinician to consider the existence and specificity of the irregular anti-erythrocytic antibodies in their obstetric patients, candidates to transfusional therapy, as well as those newborn with hemolytic diseases.
Assuntos
Sistema ABO de Grupos Sanguíneos/imunologia , Anticorpos/sangue , Eritrócitos/imunologia , Adulto , Anticorpos/classificação , Teste de Coombs , Feminino , Testes de Hemaglutinação , Humanos , Fenótipo , GravidezRESUMO
The case of a 24-year-old woman with fever, abdominal pain and weight loss, is presented. Right ovarian dysgerminoma was diagnosed; group A blood, negative direct Coombs. The search for free serum antibodies was positive, with specificity: auto anti 1, anti P with activity at 37 degrees C. Hysterectomy, appendectomy, omentectomy and retroperitoneal ganglia biopsy, were performed; the latter one showed metastasis. Blood transfusions were given. Thirty days postoperative, the red cell polyagglutination had disappeared, as well as antibodies.