Maternal human placental lactogen estimations in severe rhesus iso-immunisation before and after fetal intravascular transfusion

Stabile, Isabel; Grudzinskas, J. G.; Nicolaides, Kypros H.; Rodeck, Charles H.; Patel, Sukhpreet

doi:10.3109/01443618809008805

Cited by 2 publications

(1 citation statement)

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“…This trend with gestation contrasts with the decrease in maternal glucose reported in nor mal pregnancies [16]. This suggests that, in Rh alloimmunization, increased maternal glucose may increase placental glucose trans fer similarly to what occurs in diabetic preg nancy [ 17], The 'diabetogenicity' of Rh preg nancies might be related to the increased pla cental production of human placental lacto gen which has been reported previously [ 18], Increased placental blood flow [19] and increased fetal insulin, which are considered to be major regulating determinants of trans placental concentration gradient [20], might be additional factors promoting glucose trans fer. Decreased glucose utilization might be a further mechanism leading to hyperglycemia.…”

Section: Discussioncontrasting

confidence: 54%

Carbohydrate Metabolism in Fetuses with RH Alloimmunization

et al. 1993

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Glucose, insulin, glucagon and fructosamine were measured in the plasma of control (n = 34) and of Rh fetuses (n = 22) before the first and subsequent transfusion. Prior to treatment, Rh fetuses, compared to controls, had raised concentrations of glucose (p = 0.01), glucagon (p = 0.04) and fructosamine (p = 0.004). Fetal insulin levels were not significantly different. Before subsequent transfusion, despite correction of anemia, Rh fetuses were clearly hyperinsulinemic even after correction for gestation (p = 0.002) and had low glucagon concentrations (p = 0.01) when compared with values at the first transfusion. This metabolic milieu appears similar to that of fetuses of diabetic mothers which have increased plasma glucose and insulin during most of the last third of gestation.

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Section: Discussioncontrasting

confidence: 54%

Carbohydrate Metabolism in Fetuses with RH Alloimmunization

et al. 1993

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High‐Dose Intravenous IgG for the Treatment of Severe Rhesus Alloimmunization

1991

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The value of intravenous immunoglobulin (IVIG) in the treatment of 24 severely Rh-sensitized pregnant women was studied. IVIG was infused at a daily dose of 0.4 g/kg maternal body weight for 4-5 consecutive days, and was administered again 15-21 days later until delivery, depending on the evolution of the hemolytic disease. Our population was divided into 3 groups according to the time of onset of therapy: group 1 (n = 8), before 20 weeks' gestation; group 2 (n = 7), 20-28 weeks, and group 3 (n = 9), after 28 weeks. Initial mean anti-D level was significantly higher in group 1 (25.9 +/- 12.9 IU/ml) than in the other 2 groups, whose mean values were, however, higher than 10 IU/ml. Amniotic-fluid total bilirubin levels before the onset of therapy were pathologic, and in 55% of the cases they coincided with zone 3 of Liley's chart. Hydrops fetalis at the onset of treatment accounted for the only 3 fetal deaths in groups 1 and 2. None of the fetuses developed hydrops during treatment. Six of the 9 neonates in group 3 were depressed at birth (1-min Apgar below 7). However, at 5 min only 1 newborn showed an Apgar below 7. Mean birth weight was over 2,500 g in all the cases. Neonatal hematological condition in group 2 (50% of the babies required only phototherapy) was better than in the other 2 groups (transfusional therapy). There was a significant fall in maternal anti-D titers and intrauterine hemolysis after IVIG treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

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Maternal human placental lactogen estimations in severe rhesus iso-immunisation before and after fetal intravascular transfusion

Cited by 2 publications

References 11 publications

Carbohydrate Metabolism in Fetuses with RH Alloimmunization

Carbohydrate Metabolism in Fetuses with RH Alloimmunization

High‐Dose Intravenous IgG for the Treatment of Severe Rhesus Alloimmunization

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