Fetomaternal Transfusion
Blood Transfusion
Rh Isoimmunization
Blood Transfusion, Intrauterine
Prenatal diagnosis of acute massive fetomaternal hemorrhage. (1/54)
We present here 2 cases of acute and 2 cases of chronic massive fetomaternal hemorrhage. A sinusoidal fetal heart rate pattern may indicate chronic fetomaternal hemorrhage, but, when increased variability is observed in fetal monitoring, maternal hemoglobin F should be measured to exclude acute fetomaternal hemorrhage. (+info)An unusual concurrence of graft versus host disease caused by engraftment of maternal lymphocytes with DiGeorge anomaly. (2/54)
We describe a girl with DiGeorge anomaly and normal cytogenetic and molecular studies, whose clinical course was complicated by graft versus host disease caused by intrauterine materno-fetal transfusion, and several immunohematological alterations including a monoclonal gammapathy of undetermined significance (first IgG, which subsequently changed to IgM). The main clinical features and pathological findings are discussed. (+info)Massive transplacental hemorrhage: clinical manifestations in the newborn. (3/54)
Thirteen newborn infants had transplacental hemorrhage in excess of 30 ml. Fetal blood in the maternal circulation was demonstrated in all cases by the acid elution technique. Anemia was noted in five babies either at birth or within the first 24 hours of life. One baby was stillborn, the death possibly being related to fetal hemorrhage. The other seven babies were clinically normal in spite of massive transplacental hemorrhage. The hemoglobin values and reticulocyte counts were normal at birth and the first 5 days of life. The data on this group of babies suggest that the clinical manifestations of transplacental hemorrhage are related not only to the size of the hemorrhage but also to the time at which the hemorrhage occurs. (+info)Microchimerism in a female patient with systemic lupus erythematosus. (4/54)
Systemic lupus erythematosus (SLE) is a serious multisystem disease that has a striking propensity to affect women. The cause of SLE remains elusive. Fetomaternal cell trafficking, or the passage of fetal cells into the maternal circulation, is now a well-established phenomenon. In addition, fetal cells have been implicated in the development of preeclampsia and in the pathogenesis of scleroderma. We undertook this study to determine whether fetomaternal cell trafficking might also be involved in pathogenic processes in SLE. Fluorescence in situ hybridization analysis was performed using X and Y chromosome-specific probes on affected and unaffected tissue obtained at autopsy from a woman who had previously given birth to 2 males and who had died of complications of SLE. The goal of the analysis was to detect the presence of male cells of putative fetal origin. Male cells were found in every histologically abnormal tissue type that was examined, but were not found in histologically normal tissue. These data suggest that fetal cells may be associated with SLE. It is unclear whether their presence may be related to disease causation, an effect of disease progression, or unrelated to disease pathology. However, this case study is an important step toward understanding the potential relationship between fetomaternal cell trafficking and SLE pathology. (+info)Fetal and embryonic hemoglobins in erythroblasts from fetal blood and fetal cells enriched from maternal blood in fetal anemia. (5/54)
BACKGROUND AND OBJECTIVES: To determine whether there is a delay or reversal in switch mechanisms from embryonic (e and z) to fetal (g) hemoglobins accompanying the erythroblastosis of anemic fetuses and whether an increased erythroblast count in fetal blood is associated with an increase in feto-maternal cell trafficking. DESIGN AND METHODS: Fetal and maternal blood samples were obtained from 10 cases with rhesus isoimmunization and 2 cases with maternal Parvo-B19 virus at 19-33 weeks' gestation. Blood samples were also taken as controls from 61 fetuses and 86 mothers. Fetal erythroblasts were isolated by triple density gradient centrifugation and magnetic cell sorting with CD71 antibody. Fluorescent antibodies were used to immuno-stain for zeta (z), epsilon (e) and gamma (g) hemoglobin chains. In the maternal samples, fluorescence in situ hybridization (FISH) for X and Y chromosomes was also carried out to confirm the presence and proportion of the enriched fetal cells from maternal blood. RESULTS: In both fetal and maternal blood the percentage of erythroblasts positive for g-globin chain was significantly higher in the anemic fetuses compared to the controls (fetal blood, p<0.001, R=0.91; maternal blood, p<0.001, R=0.56), but there was no significant difference in expression of the e and z-chains. The percentage of cells with Y-signals was also higher in the maternal samples of anemic fetuses compared to normal controls (p<0.001, R=0.56). INTERPRETATION AND CONCLUSIONS: These findings suggest that the erythroblastosis of anemic fetuses is not accompanied by a delay or a reversal in switch from embryonic to fetal hemoglobin chains. Severe fetal anemia is associated with an increase in feto-maternal cell trafficking. (+info)Possible contribution of microchimerism to the pathogenesis of Sjogren's syndrome. (6/54)
OBJECTIVES: Microchimerism of foetal cells occurs during most pregnancies. Two autoimmune diseases, systemic sclerosis (SSc) and Sjogren's syndrome (SS), have many clinical and pathological similarities to chronic graft-vs-host disease (GVHD). These findings suggest that anti-maternal graft-vs-host reaction by foetal cells may be involved in the pathogenesis of the diseases. To explore this hypothesis, we examined foetal DNA in peripheral blood of 59 women and in salivary glands from 28 women. METHODS: DNA extracted from peripheral blood and the affected minor salivary glands was analysed for the Y-chromosome-specific gene using a nested polymerase chain reaction (PCR) test. In the minor salivary gland specimens, the Y-chromosome-positive foetal cells were identified by in situ hybridization with a Y-chromosome-specific DNA probe. RESULTS: In peripheral blood, there was no significant difference between controls and patients with SSc or SS. In salivary glands, foetal DNA was detected in 11 of 20 women with SS but in only one of eight normal controls using PCR test. Additionally, foetal cells were clearly detected in three out of eight women with SS by the use of in situ hybridization. CONCLUSIONS: The identification of foetal cells in salivary glands suggests that anti-maternal GVHD may be involved in the development of SS. (+info)Fetal-maternal hemorrhage detection in Ontario. (7/54)
The results from fetal-maternal hemorrhage (FMH) detection and quantitation external quality assessment surveys conducted in Ontario indicate that the rosette test had a sensitivity and specificity for an FMH of more than 10 mL of 1.0 and 0.75, respectively, compared with 0.96 and 0.92, respectively, for acid elution. With FMH quantitation, the percentage error of the mean from the target FMH was 20% or more in 7 of 8 surveys, and coefficients of variation ranged from 39.5% to 71.8%. Inadequate Rho(D) immune globulin prophylaxis could have occurred in 19.4% of the challenges with an FMH of more than 10 mL. The rosette and acid elution techniques are both effective for the detection or exclusion of FMH, but acid elution lacks adequate accuracy and precision for reliable FMH quantitation. Furthermore, a strategy of prescribing an extra 1,500-IU Rho(D) immune globulin dose, in addition to the dose required to treat the volume of fetal blood detected, is an effective strategy to overcome the limitations of FMH quantitation by acid elution. (+info)Cellular microchimerism as a lifelong physiologic status in parous women: an immunologic basis for its amplification in patients with systemic sclerosis. (8/54)
OBJECTIVE: To quantitatively measure male DNA in blood from women with systemic sclerosis (SSc) and from controls and to evaluate in vitro the modulation of the microchimeric cell population size following immunologic stimuli that were expected to trigger antigen-specific T cells. METHODS: A real-time polymerase chain reaction for a Y chromosome sequence was used to measure male DNA in blood from women with SSc and from controls who gave birth to sons. The in vitro change in the microchimeric cell population size was measured following immunologic stimuli, which were expected to trigger antigen-specific T cells. RESULTS: Cellular microchimerism was found in SSc patients and controls, but the absolute amount of male DNA was higher in the patients, and the in vitro addition to blood mononuclear cells of an anti-CD28 costimulatory signal acted as a powerful amplification of microchimeric cells in 3 patients with SSc but not in controls. CONCLUSION: Cellular microchimerism is a physiologic phenomenon in parous women. In SSc patients, cellular microchimerism is accounted for by a higher number of cells that have the characteristics of T lymphocytes specific to maternal allogeneic antigens. (+info)Fetomaternal transfusion, also known as fetal-maternal hemorrhage, is a medical condition where there is a transfer of fetal blood cells into the maternal circulation. This can occur during pregnancy, childbirth, or in the postpartum period due to various reasons such as placental abnormalities, trauma, or invasive procedures like amniocentesis. In some cases, it may lead to complications for both the fetus and the mother, including fetal anemia, hydrops fetalis, and maternal alloimmunization.
A blood transfusion is a medical procedure in which blood or its components are transferred from one individual (donor) to another (recipient) through a vein. The donated blood can be fresh whole blood, packed red blood cells, platelets, plasma, or cryoprecipitate, depending on the recipient's needs. Blood transfusions are performed to replace lost blood due to severe bleeding, treat anemia, support patients undergoing major surgeries, or manage various medical conditions such as hemophilia, thalassemia, and leukemia. The donated blood must be carefully cross-matched with the recipient's blood type to minimize the risk of transfusion reactions.
Rh isoimmunization is a condition that occurs when an Rh-negative individual (usually a woman) develops an immune response to the Rh-positive blood of another individual (usually a fetus during pregnancy or a transfused blood). The Rh-negative person's immune system recognizes the Rh-positive blood as foreign and produces antibodies against it. This sensitization can lead to hemolytic disease of the newborn if the mother becomes pregnant with another Rh-positive fetus, as the maternal antibodies can cross the placenta and attack the fetal red blood cells, potentially causing anemia, jaundice, or more severe complications.
The first exposure to Rh-positive blood typically does not cause a significant reaction because the mother's immune system has not yet produced enough antibodies. However, subsequent exposures can lead to increasingly severe reactions due to the presence of pre-existing antibodies. Preventive measures such as administering Rh immunoglobulin (RhIg) to Rh-negative women during pregnancy and after delivery help prevent sensitization and reduce the risk of hemolytic disease of the newborn.
Intrauterine blood transfusion (IUT) is a medical procedure in which blood is transfused into the fetal circulation through the umbilical vein while the fetus is still in the uterus. This procedure is typically performed to treat severe anemia in the fetus, most commonly caused by hemolytic disease of the newborn due to Rh incompatibility or ABO incompatibility between the mother and fetus.
During the procedure, ultrasound guidance is used to insert a thin needle through the mother's abdomen and uterus and into the umbilical vein of the fetus. The blood is then transfused slowly, allowing the fetal body to adjust to the increased volume. The procedure may need to be repeated every 2-4 weeks until the baby is mature enough for delivery.
IUT is a highly specialized procedure that requires significant expertise and experience in maternal-fetal medicine and interventional radiology. It carries risks such as preterm labor, infection, fetal bradycardia (abnormally slow heart rate), and fetal loss, but it can be life-saving for the fetus when performed appropriately.
An erythrocyte transfusion, also known as a red blood cell (RBC) transfusion, is the process of transferring compatible red blood cells from a donor to a recipient. This procedure is typically performed to increase the recipient's oxygen-carrying capacity, usually in situations where there is significant blood loss, anemia, or impaired red blood cell production.
During the transfusion, the donor's red blood cells are collected, typed, and tested for compatibility with the recipient's blood to minimize the risk of a transfusion reaction. Once compatible units are identified, they are infused into the recipient's circulation through a sterile intravenous (IV) line. The recipient's body will eventually eliminate the donated red blood cells within 100-120 days as part of its normal turnover process.
Erythrocyte transfusions can be lifesaving in various clinical scenarios, such as trauma, surgery, severe anemia due to chronic diseases, and hematologic disorders. However, they should only be used when necessary, as there are potential risks associated with the procedure, including allergic reactions, transmission of infectious diseases, transfusion-related acute lung injury (TRALI), and iron overload in cases of multiple transfusions.