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2016 | OriginalPaper | Buchkapitel

27. Alloimmunerkrankungen und Schwangerschaft

verfasst von : Roland Zimmermann

Erschienen in: Die Geburtshilfe

Verlag: Springer Berlin Heidelberg

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Zusammenfassung

Genetische Varianten von Oberflächenantigenen unserer Blutzellen können in einer Schwangerschaft zur Immunisierung der Mutter gegen fetale Erythrozyten, in seltenen Fällen auch Thrombozyten führen. Die wichtigste Alloimmunerkrankung, die Rhesus-D-Immunisierung, konnte durch die Einführung einer Prophylaxe zahlenmäßig stark reduziert werden. Die großen Perinatalzentren sind aber nach wie vor mit transfusionspflichtigen anämen Feten konfrontiert. In erfahrenen Händen ist die Komplikationsrate von Nabelschnurtransfusionen gering. Dieses Kapitel gibt eine Übersicht über die verschiedenen Antigensysteme, die Art der Prophylaxe und Informationen über das Vorgehen im Fall einer fetomaternalen Blutgruppeninkompatibilität.

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Akademie Feto-Maternale Medizin – AFMM (2006) Anti-D-Resusprophylaxe. Schweiz Med Forum 6:749–751

American College of Obstetricians and Gynecologists – ACOG (1999) Prevention of Rho (D) alloimmunization. Pract Bull 4. http://emupdates.com/perm/Socol%20ACOG%20Practice%20Bulletin%20Prevention%20of%20Rh%20D%20Alloimmunization%201999%20%5BReaffirmed%202010%5D.pdf

Avent ND, Reid ME (2000) The Rh blood group system: a review. Blood 95:375–387PubMed

Bolton-Maggs PHB, Davies T, Poles D, Cohen H (2013) Errors in anti-D immunoglobulin administration: retrospective analysis of 15 years of reports to the UK confidential haemovigilance scheme. BJOG 120:873–878CrossRefPubMed

Bussel JB, Zabusky MR, Berkowitz RL, McFarland JG (1997) Fetal alloimmune thrombocytopenia. N Engl J Med 337:22–26CrossRefPubMed

Cartron J-P (1994) Defining the Rh blood group antigens: biochemistry and molecular genetics. Blood Rev 8:199–212CrossRefPubMed

Chilcott J, Jones ML et al (2003) A review of the clinical effectiveness and cost-effectiveness of routine anti-D prophylaxis for pregnant women who are rhesus-negative. Health Technol Assess 7:1–72PubMed

Clausen FB, Christiansen M, Steffensen R et al (2012) Report of the first nationally implemented clinical routine screening for fetal RHD in D- pregnant women to ascertain the requirement for antenatal RhD prophylaxis. Transfusion 52:752CrossRefPubMed

Combined Study (1966) Prevention of Rh-haemolytic disease: results of the clinical trial. A combined study from centres in England and Baltimore. BMJ 2:907–914CrossRef

Daffos F, Capella-Pavlovsky M, Forestier F (1983) Fetal blood sampling via the umbilical cord using a needle guided by ultrasound. Report of 66 cases. Prenat Diagn 3:271–277CrossRefPubMed

Daffos F, Forestier F, Mac Aleese J et al (1988) Fetal curarization for prenatal magnetic resonance imaging. Prenat Diagn 8:312CrossRefPubMed

DiGuiseppi C (1996) Screening for D (rh) incompatibility. Guide to clinical preventive services. National Library of Medicine. Health Services/Technology Assessment-Text. http://text.nlm.nih.gov/cps; www/cps.44.html

Hughes RG, Craig JIO, Murphy WG, Greer IA (1994) Causes and clinical consequences of Rhesus (D) haemolytic disease of the newborn: a study of a Scottish population, 1985–1990. Br J Obstet Gynaecol 101:297–300CrossRefPubMed

Kanhai HHH, Elngelfriet HW et al (2007) Management of alloimmune thrombocytopenia. Vox Sang 93:370–385PubMed

Katzorke S (1995) Titervergleich von erythrozytären Alloantikörpern im Röhrchentest und im Geltest. Inauguraldissertation, Universität Zürich

Kjaer Killie M, Kjeldsen-Kragh J et al (2007) Cost-effectiveness of antenatal screening for neonatal alloimmune thrombocytopenia. Br J Obstet Gynaecol 114:588–595CrossRef

Kjaer Killie M, Husebeck A et al (2008) A prospective study of maternal anti-HPA 1a antibody level as a potential predictor of alloimmune thrombocytopenia in the newborn. Haematologica 93:870–877CrossRef

Kjeldsen-Kragh J, Kjaer Killie M et al (2007) A screening and intervention program aimed to reduce mortality and serious morbidity associated with severe neonatal alloimmune thrombocytopenia. Blood 110:833–839CrossRefPubMed

Kleihauer E, Braun H, Betke K (1957) Demonstration von fetalem Hämoglobin in den Erythrocyten eines Blutausstrichs. Klin Wochenschr 35:637–638CrossRefPubMed

Koelewijn JM, de Haas M et al (2008) One single dose of 200 μg of antenatal RhIG halves the risk of anti-D immunization and hemolytic disease of the fetus and newborn in the next pregnancy. Transfusion 48:1721–1729CrossRefPubMed

Koelewijn JM, de Haas M, Vrijkotte TG et al (2009) Risk factors for RhD immunisation despite antenatal and postnatal anti-D prophylaxis. BJOG 116:1307–1314CrossRefPubMedPubMedCentral

Kumpel BM, MacDonald AP, Bishop DR, Yates AF, Lee E (2013) Quantitation of fetomaternal haemorrhage and F cells in unusual maternal blood samples by flow cytometry using anti-D and anti-HbF. Transfus Med 23:175–186CrossRefPubMed

Liley AW (1961) Liquor amnii analysis in management of pregnancy complicated by rhesus sensitization. Am J Obstet Gynecol 82:1359–1364PubMed

Mari G, Adrignolo A, Abuhamad AZ, Pirhonen J, Jones DC, Ludomirsky A, Copel JA (1995) Diagnosis of fetal anemia with doppler ultrasound in the pregnancy complicated by maternal blood group immunization. Ultrasound Obstet Gynecol 5:400–405CrossRefPubMed

Mari GC, Deter RL, Carpenter R et al (2000) Non-invasive diagnosis by doppler ultrasonography of fetal anemia due to maternal alloimmunization. N Engl J Med 342:9–14CrossRefPubMed

Mollison PL, Engelfriet CP, Contretras M (1993) Blood transfusion in clinical medicine. Blackwell, Oxford

Nance SJ, Nelson JM, Horenstein J, Arndt P, Platt LD, Garatty G (1989) Monocyte monolayer assay: an efficient non-invasive technique for predicting the severity of hemolytic disease of the newborn. Am J Clin Pathol 92:89–92CrossRefPubMed

Nicolaides KH (1993) Management of red blood cell isoimmunized pregnancies. In: Chervenak FA, Isaacson GC, Campbell S (Hrsg) Ultrasound in obstetrics and gynecology. Little & Brown, Boston, S 1543–1555

Nicolaides KH, Rodeck CH (1992) Maternal serum anti-D antibody concentration and assessment of rhesus isoimmunisation. BMJ 304:1155–1156CrossRefPubMedPubMedCentral

Oepkes D (1993) Ultrasonography and doppler in the management of red cell alloimmunized pregnancies. Inauguraldissertation, Universität Leiden

Oepkes D, Seaward PG et al (2006) Doppler ultrasonography versus amniocentesis to predict fetal anemia. N Engl J Med 355:156–164CrossRefPubMed

Porra V, Bernaud J, Bernaud J, Gueret P, Bricca P, Rigal D, Follea G, Blanchard D (2007) Identification and quantification of fetal red blood cells in maternal blood by a dual-color flow cytometric method: evaluation of the fetal cell count kit. Transfusion 47:1281–1289CrossRefPubMed

Thomas JT, Muller P, Wilkinson CS (2007) Antenatal phenobarbital for reducing neonatal jaundice after red cell isoimmunisation. Cochrane Database Syst Rev (2):CD005541. doi:10.1002/14651858.CD005541.pub2

Van den Acker ESA, Oepkes D (2008) Fetal and neonatal alloimmune thrombocytopenia. Best Pract Res Clin Obstet Gynaecol 22:3–14CrossRef

Van der Schoot CE, Hahn S et al (2008) Non-invasive diagnosis and determination of fetal Rh status. Sem Fetal Neonatal Med 13:63–68CrossRef

Van der Schoot CE, de Haas M et al (2009) Genotyping for red blood cell polymorphism. Vox Sang 96:167–179CrossRefPubMed

Vetter K, Favre Y (1990) Moderne Diagnostik und Therapie bei fetomaternaler Blutgruppenunvertraglichkeit. Arch Obstet Gynaecol 247:S25–S35

Walker W (1970) Phenobarbitone in rhesus haemolytic disease. Lancet 2:1089–1090CrossRefPubMed

Wikman AT, Tiblad E, Karlsson A et al (2012) Non-invasive single-exon fetal RHD determination in a routine screening program in early pregnancy. Obstet Gynecol 120:227CrossRefPubMed

Zimmermann R, Huch A (1992) In utero fetal therapy with IgG for alloimmunthrombocytopenia. Lancet 340:606CrossRefPubMed

Zimmermann R, Gmür J, Tuchschmid P (1993) Fetale und neonatale Alloimmunthrombozytopenie (eh. Iso-Immun-). Schweiz Med Wochenschr 123:1655–1661PubMed

Zimmermann R, Durig P, Carpenter RJJ, Mari G (2002) Longitudinal measurement of peak systolic velocity in the fetal middle cerebral artery for monitoring pregnancies complicated by re-cell alloimmunization – a prospective multi-center trial with intention to treat. Br J Obstet Gynaecol 109:746–752CrossRef

Titel: Alloimmunerkrankungen und Schwangerschaft
verfasst von: Roland Zimmermann
Verlag: Springer Berlin Heidelberg
Buch: Die Geburtshilfe
Print ISBN: 978-3-662-45063-5

Electronic ISBN: 978-3-662-45064-2

Copyright-Jahr: 2016
DOI: https://doi.org/10.1007/978-3-662-45064-2_27

Springerpflege

Zusammenfassung

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