Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis.
To access publisher's full text version of this article click on the hyperlink below Background: Rhesus D (RhD) incompatibility is still the most important cause of hemolytic disease of the fetus and newborn (HDFN) worldwide. The aim of this study was to investigate the incidence, causes, and c...
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Online Access: | http://hdl.handle.net/2336/621264 https://doi.org/10.1111/trf.15635 |
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/621264 2023-05-15T16:46:44+02:00 Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. Gudlaugsson, Brynjar Hjartardottir, Hulda Svansdottir, Gudrun Gudmundsdottir, Gudny Kjartansson, Sveinn Jonsson, Thorbjorn Gudmundsson, Sveinn Halldorsdottir, Anna M 1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Department of Obstetrics and Gynecology, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. 3Blood Bank, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. 4Department of Pediatrics, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. 2020-01 http://hdl.handle.net/2336/621264 https://doi.org/10.1111/trf.15635 en eng Wiley https://onlinelibrary.wiley.com/doi/full/10.1111/trf.15635 Gudlaugsson B, Hjartardottir H, Svansdottir G, et al. Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. Transfusion. 2020;60(1):175–183. doi:10.1111/trf.15635 31850521 doi:10.1111/trf.15635 http://hdl.handle.net/2336/621264 1537-2995 Transfusion © 2019 AABB. National Consortium - Landsaðgangur Transfusion 60 1 175 183 United States Blóðflokkar Mótefni Rh-Hr Blood-Group System Article 2020 ftlandspitaliuni https://doi.org/10.1111/trf.15635 2022-05-29T08:22:31Z To access publisher's full text version of this article click on the hyperlink below Background: Rhesus D (RhD) incompatibility is still the most important cause of hemolytic disease of the fetus and newborn (HDFN) worldwide. The aim of this study was to investigate the incidence, causes, and consequences of anti-D alloimmunizations in pregnancy in Iceland, prior to implementation of targeted routine antenatal anti-D prophylaxis (RAADP) in 2018. Study design and methods: This was a nation-wide cohort study of 130 pregnancies affected by RhD alloimmunization in Iceland in the period from 1996 through 2015. Data were collected from transfusion medicine databases, medical records, and the Icelandic Medical Birth Register. Results: Of 130 RhD alloimmunizations, 80 cases (61.5%) represented new RhD immunization in the current pregnancy. Sensitization was discovered in the third trimester in 41 (51.3%) and occurred in the first pregnancy in 14 cases (17.5%). The most likely causative immunization event was the index pregnancy for 45 (56.25%), a previous pregnancy/birth for 26 (32.5%), abortion for 3 (3.75%), and unknown for 6 women (7.5%). Higher anti-D titers were associated with shorter gestational length, cesarean sections, positive direct antiglobulin test (DAT), and severe HDFN. Intrauterine transfusion (IUT) was performed in five pregnancies (3.8%), and 35 of 132 (26.5%) live-born neonates received treatment for HDFN; 32 received phototherapy (24.2%), 13 exchange transfusion (9.8%), and seven simple blood transfusion (5.3%). Conclusion: In about half of cases, RhD alloimmunization was caused by the index pregnancy and discovered in the third trimester. Thus, the newly implemented RAADP protocol should be effective in reducing the incidence of RhD immunization in Iceland in the future. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Transfusion 60 1 175 183 |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Blóðflokkar Mótefni Rh-Hr Blood-Group System |
spellingShingle |
Blóðflokkar Mótefni Rh-Hr Blood-Group System Gudlaugsson, Brynjar Hjartardottir, Hulda Svansdottir, Gudrun Gudmundsdottir, Gudny Kjartansson, Sveinn Jonsson, Thorbjorn Gudmundsson, Sveinn Halldorsdottir, Anna M Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
topic_facet |
Blóðflokkar Mótefni Rh-Hr Blood-Group System |
description |
To access publisher's full text version of this article click on the hyperlink below Background: Rhesus D (RhD) incompatibility is still the most important cause of hemolytic disease of the fetus and newborn (HDFN) worldwide. The aim of this study was to investigate the incidence, causes, and consequences of anti-D alloimmunizations in pregnancy in Iceland, prior to implementation of targeted routine antenatal anti-D prophylaxis (RAADP) in 2018. Study design and methods: This was a nation-wide cohort study of 130 pregnancies affected by RhD alloimmunization in Iceland in the period from 1996 through 2015. Data were collected from transfusion medicine databases, medical records, and the Icelandic Medical Birth Register. Results: Of 130 RhD alloimmunizations, 80 cases (61.5%) represented new RhD immunization in the current pregnancy. Sensitization was discovered in the third trimester in 41 (51.3%) and occurred in the first pregnancy in 14 cases (17.5%). The most likely causative immunization event was the index pregnancy for 45 (56.25%), a previous pregnancy/birth for 26 (32.5%), abortion for 3 (3.75%), and unknown for 6 women (7.5%). Higher anti-D titers were associated with shorter gestational length, cesarean sections, positive direct antiglobulin test (DAT), and severe HDFN. Intrauterine transfusion (IUT) was performed in five pregnancies (3.8%), and 35 of 132 (26.5%) live-born neonates received treatment for HDFN; 32 received phototherapy (24.2%), 13 exchange transfusion (9.8%), and seven simple blood transfusion (5.3%). Conclusion: In about half of cases, RhD alloimmunization was caused by the index pregnancy and discovered in the third trimester. Thus, the newly implemented RAADP protocol should be effective in reducing the incidence of RhD immunization in Iceland in the future. |
author2 |
1Faculty of Medicine, University of Iceland, Reykjavik, Iceland. 2Department of Obstetrics and Gynecology, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. 3Blood Bank, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. 4Department of Pediatrics, Landspitali -The National University Hospital of Iceland, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Gudlaugsson, Brynjar Hjartardottir, Hulda Svansdottir, Gudrun Gudmundsdottir, Gudny Kjartansson, Sveinn Jonsson, Thorbjorn Gudmundsson, Sveinn Halldorsdottir, Anna M |
author_facet |
Gudlaugsson, Brynjar Hjartardottir, Hulda Svansdottir, Gudrun Gudmundsdottir, Gudny Kjartansson, Sveinn Jonsson, Thorbjorn Gudmundsson, Sveinn Halldorsdottir, Anna M |
author_sort |
Gudlaugsson, Brynjar |
title |
Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
title_short |
Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
title_full |
Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
title_fullStr |
Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
title_full_unstemmed |
Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. |
title_sort |
rhesus d alloimmunization in pregnancy from 1996 to 2015 in iceland: a nation-wide population study prior to routine antenatal anti-d prophylaxis. |
publisher |
Wiley |
publishDate |
2020 |
url |
http://hdl.handle.net/2336/621264 https://doi.org/10.1111/trf.15635 |
genre |
Iceland |
genre_facet |
Iceland |
op_source |
Transfusion 60 1 175 183 United States |
op_relation |
https://onlinelibrary.wiley.com/doi/full/10.1111/trf.15635 Gudlaugsson B, Hjartardottir H, Svansdottir G, et al. Rhesus D alloimmunization in pregnancy from 1996 to 2015 in Iceland: a nation-wide population study prior to routine antenatal anti-D prophylaxis. Transfusion. 2020;60(1):175–183. doi:10.1111/trf.15635 31850521 doi:10.1111/trf.15635 http://hdl.handle.net/2336/621264 1537-2995 Transfusion |
op_rights |
© 2019 AABB. National Consortium - Landsaðgangur |
op_doi |
https://doi.org/10.1111/trf.15635 |
container_title |
Transfusion |
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60 |
container_issue |
1 |
container_start_page |
175 |
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183 |
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1766036836996612096 |