ABO-isoimmunization prognosis

详细

Objective: predelivery prognosis of immunoconflict in the course of clinical observation of ABO-incompatible pregnancy.

全文:

Methods: 177 pregnants and their new-born infants were examined. Peculiarities of anamnesis are studied, significance of serologic methods of diagnosis is determined, some clinico-laboratorial indices are estimated (bilirubin, electrolytes K+, Na+, hemoglobin, erythrocytes and their correlation). For the first time condition of hemomicrocirculation at ABO-incompatible pregnancy and the conjunctiva index are studied with the help of biomicroscopy of eyeball conjunctiva vessels in the area of the external corner of an eye. A statistical programme Statgraf was used for quantitative treatment of the data.

Results: analysis of the pregnant’s Rhesus-factor dependence of ABО-immunization is carried out. In the course of determination of the group agglutinins titre with the help of parallel agglutination in the salt and serum medium, four variants of the group agglutinins titre level are revealed in the ABО-isoimmunized pregnants. Peculiarities of their dynamics and correspondence to the level of severity of the hemolytic disease of newborn are revealed too. Besides it is found out that the erythrocytes, hemoglobin and bilirubin indices are pronouncely dependent on indices of the level of electrolytes K+ and Na+ (r=0.889, p<0.05). Study of hemomicrocirculation in the ABО-isoimmunized pregnants revealed definite changes of ratio between the arteriola and venule diameter and bloodflow.

Conclusion: More accurate determination of possible ABO-isoimmunization of a pregnant may be achieved only by complex use of anamnestic and clinical data. The most valuable of them are: 1) dynamic study of the group antibody titre of a pregnant with the help of the husband's erythrocytes, 2) study of indices of hemoglobin, erythrocytes and electrolytes (K+, Na+) level, 3) hemomicrocirculation.