Rodriguez Stephanie, DeChristopher Phillip J, Krum Kristen, Lal Ann
Department of Maternal Fetal Medicine, Loyola University Medical Center, Illinois.
Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Illinois.
AJP Rep. 2024 Sep 30;14(3):e228-e230. doi: 10.1055/s-0044-1791525. eCollection 2024 Jul.
The rhesus factor D (RhD)-negative patients who give birth to an RhD-positive newborn or who are otherwise exposed to RhD-positive red blood cells are at risk of developing anti-D antibodies. These antibodies may cause hemolytic disease of the fetus and newborn (HDFN). During pregnancy, prevention of alloimmunization is completed with a Rho(D) immune globulin (RhIg). We report two cases, where obese patients developed alloimmunization, with high neonatal titers, after appropriate RhIG prophylaxis during the index pregnancy. Our cases demonstrate cases of anti D-alloimmunization in an index pregnancy, with high neonatal titers. Both patients are obese, with BMI > 35 mg/m . RhIG can be administered via intramuscular or intravenous formulations. Overall, it appears that both formulations are equally effective. The optimal administration, especially with obese women, is not clearly established.Our cases demonstrate that obesity is a risk factor for failure of RhIG, and could lead to an increase in HDFN.
分娩出RhD阳性新生儿或通过其他方式接触RhD阳性红细胞的RhD阴性患者有产生抗D抗体的风险。这些抗体可能会导致胎儿和新生儿溶血病（HDFN）。在孕期，通过注射Rho(D)免疫球蛋白（RhIg）来预防同种免疫。我们报告了两例病例，肥胖患者在首次妊娠期间接受了适当的RhIG预防后仍发生了同种免疫，且新生儿抗体效价很高。我们的病例显示了首次妊娠期间发生抗D同种免疫且新生儿抗体效价很高的情况。两名患者均为肥胖者，体重指数（BMI）> 35mg/m 。RhIG可以通过肌肉注射或静脉注射的方式给药。总体而言，这两种给药方式似乎同样有效。尤其是对于肥胖女性，最佳给药方式尚未明确确定。我们的病例表明，肥胖是RhIG失效的一个风险因素，并可能导致HDFN发病率增加。
