The effect of intrauterine intravascular blood transfusion on iron metabolism in fetuses with Rh alloimmunization

Article Abstract:

Rh alloimmunization can develop in the fetus when antibodies to the Rh factor produced by an Rh-negative mother are passed into the blood of the fetus, which may not be Rh-negative. In severe cases, a number of blood transfusions to the fetus may be required. It is thought that these transfusions can cause an overload of iron in the fetus. Iron required by the fetus in its development is normally obtained from the mother across the placenta. Excessive iron can cause tissue damage in the fetus. Fetal iron overload can be detected by measuring levels of fetal serum ferritin, the storage form of iron. Serum ferritin levels were measured in 43 normal fetuses and in 23 fetuses with Rh alloimmunization that were given blood transfusions. Results showed that in normal fetuses, plasma ferritin levels were correlated with the stage of development, with a gradual increase in levels with advanced development. In the Rh fetuses, levels were higher than the control values for 63 percent of the samples. These levels were higher even before the first transfusions, but were lower as fetal hematocrit (the volume of red blood cells in a given volume of blood) was higher. This would indicate that an increase in anemia, as seen by lower hematocrit, was related to an increase in iron stores, as evidenced by increased plasma ferritin. The plasma ferritin levels increased with transfusions, with levels being correlated to the total volume of blood transfused. These results indicate that blood transfusions given to Rh alloimmunized fetuses may put the fetuses at risk for iron overload. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Iron in the body, Iron (Nutrient), Blood transfusion, Intrauterine, Intrauterine blood transfusion

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Placental isoferritin measured by a specific monoclonal antibody as a predictive marker for preterm contraction outcome

Article Abstract:

Preterm delivery, which is associated with poor fetal outcome, is responsible for 50-70 percent of all fetal deaths. In the absence of a biological marker indicating impending preterm labor, a diagnosis of true preterm labor is obscured by the high incidence of false labor. Ferritin, a stored form of iron, and isoferritin, ferritin found in the placenta, can be measured in maternal blood. A previous study by the authors showed that isoferritin was low or absent in women who delivered prematurely. To see if isoferritin is a useful predictor of preterm labor, ferritin and isoferritin levels were studied in 25 women experiencing contractions before 28.8 weeks of pregnancy and in 14 women having uncomplicated pregnancies. The test for isoferritin employed a monoclonal antibody which binds to placental-type isoferritin. Placental isoferritin was significantly lower in the women with premature contractions (15.3 Units per milliliter; U/mL) than in the women with uncomplicated pregnancies (87.6 U/mL). The level of circulating ferritin was 30.6 U/mL in the women with preterm contractions, compared with 67 U/mL in women having a normal pregnancy. However, ferritin levels were within the normal range for both groups. Low isoferritin correctly identified 59 percent of the cases of preterm contractions. Although the direct association of low placental isoferritin and preterm delivery has not been confirmed, it is a useful marker in predicting preterm delivery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Prognosis, Premature labor, Monoclonal antibodies

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Inhibition of erythroid progenitor cells by anti-Kell antibodies in fetal alloimmune anemia

Article Abstract:

Anti-Kell antibodies in pregnant women may cause anemia in their fetus. Kell antigens are proteins that reside on the surface of red blood cells, the principle one being K1. If a pregnant women is K1-negative but her fetus is K1-positive, she will produce anti-Kell antibodies that can cross the placenta. Researchers tested the growth of red blood cell precursor cells from cord blood by exposing them to blood samples from 22 women with anti-Kell antibodies. The samples inhibited the growth of the Kell-positive precursor cells but not the Kell-negative cells. If the production of red blood cells is inhibited, the fetus will develop anemia.

Autoantibodies, Causes of, Hematopoietic stem cells

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