Does midtrimester delta OD (optical density) sub 450 of amniotic fluid reflect severity of Rh disease?

Article Abstract:

Erythroblastosis fetalis is a disease of a fetus or newborn caused by maternal-fetal blood incompatibility. A mother with type Rh negative blood can have developed Rh positive antibodies from a previous pregnancy. The Rh positive antibodies then enter the bloodstream in the fetus, causing a breakdown in fetal red cells (hemolytic anemia). This potentially fatal condition can occur even though pregnant mothers who are Rh negative may receive an injection to prevent this problem. To avoid invasive and risky fetal umbilical cord sampling, delta optical density analysis of amniotic fluid, the fluid surrounding the fetus during pregnancy, can be used to measure a byproduct of fetal blood cell destruction as an indicator of the severity of Rh disease. This method, when performed during the third trimester (from the 27th week of pregnancy to birth) allowed early delivery decisions to be made. However, some unnecessary premature deaths occurred may have been prevented if even earlier intervention had been possible. Midtrimester (weeks 16-27 of pregnancy) evaluation by delta optical density analysis would permit fetal transfusions to begin early, allowing the fetus more time to mature. Consecutive amniotic tests were performed on 32 patients having Rh-immunized pregnancies. Delta optical density values of grater than 0.15 indicated severe Rh disease. Values of less than 0.09 revealed mild or no Rh disease. Any number in between should have follow-up serial testing. Fetuses with severe Rh immunization should confirm the diagnosis with fetal umbilical cord sampling so blood transfusion can begin.

Research, Causes of, Hemolysis and hemolysins, Hemolysis, Hemolytic anemia, Rh factor

---

Deviation in amniotic fluid optical density at a wavelength of 450 nm in Rh-immunized pregnancies from 14 to 40 weeks' gestation: a proposal for clinical management

Article Abstract:

Measuring the optical density of amniotic fluid at a wavelength of 450 nanometers (nm) throughout an Rh-immunized pregnancy may detect fetuses at risk of erythroblastosis fetalis. An Rh-immunized pregnancy is one in which an Rh-negative mother has antibodies against the Rh-factor, which she developed during a previous pregnancy. If her fetus is Rh-positive, the antibodies can attack its red blood cells, causing the anemia characteristic of erythroblastosis fetalis. The optical density of amniotic fluid samples from 538 Rh-immunized pregnant women was measured every week between 14 weeks until delivery. Seventy-five Rh-positive fetuses were affected by varying degrees of anemia, and in most cases, their amniotic fluid optical density was significantly higher than RH-negative fetuses. In addition, the optical density remained high throughout the pregnancy, while the optical density in Rh-negative fetuses declined after the 26th week.

Diagnosis, Fetal death

---

What is a good physician in this new era?

Article Abstract:

Several changes in medicine since the 1950's will have an impact on medical education. The amount of medical information has exploded since then and medical students must learn this information while still absorbing the basics. They must be taught defensive medicine since malpractice suits are still common. They must be taught how to practice medicine in the age of managed care and they must be taught how to use the computerized information systems that will become common in the health care industry.

Medical students, Education, Study and teaching, Health care reform

Similar abstracts:

• Abstracts: From angiogenesis to neuropathology. A phase 1 clinical trial of nerve growth factor gene therapy for Alzheimer disease
• Abstracts: Long-term mortality after 5-year multifactorial primary prevention of cardiovascular diseases in middle-aged men
• Abstracts: Too much informed consent? Relationship of bacteriologic characteristics to semen indices in men attending an infertility clinic
• Abstracts: Classification of endometrial cells on cervical cytology. The significance of moderate and severe inflammation on class I Papanicolaou smear
• Abstracts: Bacteriologic findings of post-cesarean endometritis in adolescents. Ticarcillin/clavulanic acid versus clindamycin and gentamicin in the treatment of post-cesarean endometritis following antibiotic prophylaxis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.