Biomaterial Database

Successful treatment of extremely severe fetal anemia due to anti-Jra alloimmunization. 2006

Yuki Ishihara, and Shigeki Miyata, and Yoshihide Chiba, and Takeshi Kawai

Department of Perinatology, National Cardiovascular Center, Suita, Osaka, Japan.

BACKGROUND Although Jr(a) hemolytic disease of the newborn (HDN) is generally considered to be mild, we encountered a case of anti-Jr(a) alloimmunization hydrops fetalis due to extremely severe fetal anemia that required aggressive intrauterine treatment. METHODS A Japanese woman developed hydrops fetalis at the 29th week of gestation. Blood examination was highly positive for anti-Jr(a) antibodies. Cordocentesis demonstrated that the fetus had anti-Jr(a) antibodies and the lowest fetal hemoglobin concentration was 2.3 g/dl. After a total of four intravascular transfusions, fetal hydrops improved and a healthy girl of 2,120 g was delivered at the 35th week of gestation. The initial neonatal hemoglobin concentration at birth was 7.2 g/dl. After two straight transfusions, the infant's anemia did not worsen. Anti-Jr(a) antibodies became negative without developing hyperbilirubinemia. CONCLUSIONS The incidence of Jr(a) negativity can lead to underestimation of the risk of Jr(a) alloimmunization. This case shows that anti-Jr(a) alloimmunization may cause HDN and hydrops fetalis.

UI	MeSH Term	Description	Entries
D007518	Isoantibodies	Antibodies from an individual that react with ISOANTIGENS of another individual of the same species.	Alloantibodies
D011247	Pregnancy	The status during which female mammals carry their developing young (EMBRYOS or FETUSES) in utero before birth, beginning from FERTILIZATION to BIRTH.	Gestation,Pregnancies
D011256	Pregnancy Outcome	Results of conception and ensuing pregnancy, including LIVE BIRTH; STILLBIRTH; or SPONTANEOUS ABORTION. The outcome may follow natural or artificial insemination or any of the various ASSISTED REPRODUCTIVE TECHNIQUES, such as EMBRYO TRANSFER or FERTILIZATION IN VITRO.	Outcome, Pregnancy,Outcomes, Pregnancy,Pregnancy Outcomes
D001787	Blood Group Incompatibility	An antigenic mismatch between donor and recipient blood. Antibodies present in the recipient's serum may be directed against antigens in the donor product. Such a mismatch may result in a transfusion reaction in which, for example, donor blood is hemolyzed. (From Saunders Dictionary & Encyclopedia of Laboratory Medicine and Technology, 1984).	ABO Compatibility,ABO Incompatibility,Blood Group ABO Incompatibility,Blood Type Incompatibility,Rh Compatibility,Rh Incompatibility,ABO Compatibilities,ABO Incompatibilities,Blood Group Incompatibilities,Blood Type Incompatibilities,Compatibility, ABO,Compatibility, Rh,Incompatibilities, Blood Group,Incompatibility, ABO,Incompatibility, Blood Group,Incompatibility, Blood Type,Incompatibility, Rh,Rh Compatibilities,Rh Incompatibilities
D001789	Blood Group Antigens	Sets of cell surface antigens located on BLOOD CELLS. They are usually membrane GLYCOPROTEINS or GLYCOLIPIDS that are antigenically distinguished by their carbohydrate moieties.	Blood Group,Blood Group Antigen,Blood Groups,Antigen, Blood Group,Antigens, Blood Group,Group Antigen, Blood,Group, Blood,Groups, Blood
D001805	Blood Transfusion, Intrauterine	In utero transfusion of BLOOD into the FETUS for the treatment of FETAL DISEASES, such as fetal erythroblastosis (ERYTHROBLASTOSIS, FETAL).	Fetal Transfusion,Intrauterine Transfusion,Blood Transfusions, Intrauterine,Fetal Transfusions,Intrauterine Blood Transfusion,Intrauterine Blood Transfusions,Intrauterine Transfusions,Transfusion, Fetal,Transfusion, Intrauterine,Transfusion, Intrauterine Blood,Transfusions, Fetal,Transfusions, Intrauterine,Transfusions, Intrauterine Blood
D005260	Female		Females
D005312	Fetal Blood	Blood of the fetus. Exchange of nutrients and waste between the fetal and maternal blood occurs via the PLACENTA. The cord blood is blood contained in the umbilical vessels (UMBILICAL CORD) at the time of delivery.	Cord Blood,Umbilical Cord Blood,Blood, Cord,Blood, Fetal,Blood, Umbilical Cord,Bloods, Cord,Bloods, Fetal,Bloods, Umbilical Cord,Cord Blood, Umbilical,Cord Bloods,Cord Bloods, Umbilical,Fetal Bloods,Umbilical Cord Bloods
D005315	Fetal Diseases	Pathophysiological conditions of the FETUS in the UTERUS. Some fetal diseases may be treated with FETAL THERAPIES.	Embryopathies,Disease, Fetal,Diseases, Fetal,Embryopathy,Fetal Disease
D005865	Gestational Age	The age of the conceptus, beginning from the time of FERTILIZATION. In clinical obstetrics, the gestational age is often estimated from the onset of the last MENSTRUATION which is about 2 weeks before OVULATION and fertilization. It is also estimated to begin from fertilization, estrus, coitus, or artificial insemination.	Embryologic Age,Fetal Maturity, Chronologic,Chronologic Fetal Maturity,Fetal Age,Maturity, Chronologic Fetal,Age, Embryologic,Age, Fetal,Age, Gestational,Ages, Embryologic,Ages, Fetal,Ages, Gestational,Embryologic Ages,Fetal Ages,Gestational Ages