M. David, J. Smidt, F.C.K. Chen, U. Stein, J.W. Dudenhausen
Risk factors for fetal-to-maternal transfusion in Rh D-negative women – results of a prospective study on 942 pregnant women
Aims: To investigate the incidence of severe fetal-to-maternal
transfusion after delivery and to identify risk
factors.
Material and methods: In a prospective study at the
Department of Obstetrics, Charité, Campus Virchow-
Klinikum, Berlin, Germany, we analyzed the incidence of
severe fetal-to-maternal transfusion (>10 ml) and fetalto-
maternal hemorrhage (>25 ml) in Rh D-negative pregnant
women after delivery of Rh D-positive infants. 942
women were included in the study and Kleihauer-Betke
tests were performed. The results were compared to
perinatal data.
Results: Fetal-to-maternal hemorrhage occurred in 13
cases out of 942 (incidence of 1.3%) and severe fetalto-
maternal transfusion in 61 cases (6.5%). In all of the
cases with fetal-to-maternal hemorrhage, mothers were
compatible with their infants in ABO-system. The incidence
of fetal-to-maternal transfusion and its severe
form was significantly higher in twin pregnancies (7/21
cases and 5/21 cases respectively, 33.3% and 23.8%)
than in singleton pregnancies (22.5% and 5.9%,
P<0.001). All other factors, such as maternal age, parity,
ethnicity, mode of delivery, presentation, duration of first
and second stage of labor, CTG, or Apgar score were not
associated with an increased risk of severe fetal-to
maternal transfusion.
Conclusions: Twin pregnancy is the only independent
risk factor for severe fetal-to-maternal transfusion. ABO-incompatibility
between mother and infant seems to be
protective against Rh D-alloimmunization.
Journal of Perinatal Medicine, Walter de Gruyter
Print ISSN: 1619-3997
Volume: 32, 05/2004
Pages: 254 - 257
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