Introduction of maternal and foetal morphological parameters of blood for calculation the postpartum anti-RhD immunoglobulin doses
Journal Title: Postępy Nauk Medycznych - Year 2012, Vol 25, Issue 7
Abstract
<b>Introduction.</b> Doses of anti-RhD Ig for immunoprophylaxis of haemolytic disease of newborn (HDN) are established with reference to the volume of RhD positive foetal red blood cells in the circulation of RhD negative person. However, results obtained from flow cytometry, microscopic Kleihauer-Betke test or serological tests represent percentage of foetal cells in mother’s blood sample. Since 20 μg of anti-RhD can neutralise 1 ml of foetal RBCs, it is important to estimate the FMH volume in order to apply the appropriate dose of anti-RhD Ig.<br><b>Methods. </b>Two formulas: 1<sup>st</sup> with average values of blood count and 2<sup>nd</sup> based on mother’s body weight and Hct, maternal and foetal MCV measured in 58 women and their newborns.<br><b>Results.</b> Mean values of measured maternal morphological parameters were close to the average values in population of women and newborns but the ranges of these used for FMH volume calculation were wide ex. Hct 25.7-46.2%, body weight 48-99 kg, calculated volume of maternal blood 3600-7425 ml and ratio of foetal MCV to maternal MCV 1.04-1.41. For 1% FMH we predicted 4 doses of anti-RhD Ig 750 IU (150 μg) using the 1<sup>st</sup> formula and using 2<sup>nd</sup> formula 2, 3, 4, 5 or 6 doses depending on the woman and her newborn parameters.<br><b>Conclusions.</b> The formula with individual maternal and foetal morphological parameters is much more accurate for calculation of the volume of FMH and anti-RhD Ig doses compared with routinely used formula with average values.
Authors and Affiliations
Agata Gieleżyńska, Jadwiga Fabijańska-Mitek, Marzena Dębska
Keywords
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