Immunoprophylaxis for rhesus disease - expensive but worth it?

Article Abstract:

Hemolytic disease of the newborn (HDN), also called erythroblastosis fetalis, is a disease that destroys red blood cells. This disease can occur when the mother's blood type is Rh (rhesus) negative and fetus is Rh positive. During child birth, some of the blood from the baby gets into the mother's blood stream. An Rh negative mother, after giving birth to her first Rh positive baby, begins to make antibodies (called anti-Rh antibodies) that will destroy Rh positive red blood cells. When the mother becomes pregnant with her second Rh positive baby, her antibodies are passed across the placenta to the fetus. Once inside the fetus, these antibodies destroy the red blood cells. This causes anemia and jaundice in the newborn infant, and in severe cases, can result in brain damage and death. To prevent HDN, Rh negative mothers are given an injection of Rho(D) immune globulin, which destroys all of the Rh positive blood cells that were passed from the baby to the mother during childbirth. This prevents the mother from making the anti-Rh antibodies that could cause HDN in future pregnancies. Before this treatment was available, 15 out of every 10,000 babies died from HDN. Immunization of Rh negative mothers has reduced the fetal death rate to approximately 1 out of every 20,000 births. Studies that have examined the cost of providing immunization for Rh negative mothers have concluded that it costs almost three times less to immunize the mother than to treat newborn infants with HDN. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Prevention, Erythroblastosis fetalis, editorial, Rho(D) immune globulin

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The timing of congenital brachial plexus injury: a study of electromyography findings in the newborn piglet

Article Abstract:

It may be inaccurate to use adult nerve injuries as a model for fetal nerve injuries in obstetric malpractice cases. One consequence of a difficult delivery is injury to the infants' nerves. The nerves might also be injured before delivery and one court decided that evidence of nerve injury up to 7 days after birth could be prenatal. However, this court decision was based on research on adult nerve injuries. Researchers used adult and fetal pigs to show that evidence of nerve injury can manifest between 24 to 48 hours in the fetal pigs but not until 5 to 8 days after injury in the adult pigs.

Research, Injuries, Fetus, Wounds and injuries, Brachial plexus

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