Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report

INTRODUCTION This case report traces the diagnostic and therapeutic process of the Immuno-Transfusion Service in a case of fetal anaemia characterized by various inconsistencies between clinical and laboratory data. The paper describes an alternative technique implemented with the aim of reso...

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Main Authors: Eleonora Donno, Jessica Di Monte, Manuela Di Mascio, Tiziana Orsini, Annalisa Di Valerio, Luisa Pinti, Paola Massaro, Seila Scardapane, Francesca Fusilli, Franco Salvatore, Amalia Procida, Antonio Esposito
Format: Article
Language:English
Published: Università degli Studi di Torino 2023-06-01
Series:Journal of Biomedical Practitioners
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Online Access:https://ojs.unito.it/index.php/jbp/article/view/7771
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author Eleonora Donno
Jessica Di Monte
Manuela Di Mascio
Tiziana Orsini
Annalisa Di Valerio
Luisa Pinti
Paola Massaro
Seila Scardapane
Francesca Fusilli
Franco Salvatore
Amalia Procida
Antonio Esposito
author_facet Eleonora Donno
Jessica Di Monte
Manuela Di Mascio
Tiziana Orsini
Annalisa Di Valerio
Luisa Pinti
Paola Massaro
Seila Scardapane
Francesca Fusilli
Franco Salvatore
Amalia Procida
Antonio Esposito
author_sort Eleonora Donno
collection DOAJ
description INTRODUCTION This case report traces the diagnostic and therapeutic process of the Immuno-Transfusion Service in a case of fetal anaemia characterized by various inconsistencies between clinical and laboratory data. The paper describes an alternative technique implemented with the aim of resolving incompatibilities between positive IAT and negative DAT. In addition, the algorithm necessary to reach a diagnosis in a transfusion medicine laboratory is traced, namely, the performance of first- and second-level immuno-haematological tests, the evaluation of fetal clinical signs, and the preparation of blood components necessary for intrauterine transfusion. CASE PRESENTATION The case involves a pregnant woman who comes to the Immuno-Transfusion Service following a positive Indirect Antiglobulin Test and fetal anaemia. The main questions relate not only the presence of immunization in the woman, which should have been avoided by immunoprophylaxis (being group 0 Rh negative), but also the stability of the antibody titer (or level) throughout the pregnancy, fetal recovery after TIU, and the presence of a negative Direct Antiglobulin Test. CONCLUSIONS Questions that were completely resolved at caesarean section with the discovery of a giant chorioangioma that, by sequestering fetal red blood cells, caused anaemia and the confirmation of a rare blood phenotype of the father that caused the woman's immunization.
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spelling doaj.art-c83245f1007542fa87c8241da9a72ea12023-06-26T06:50:02ZengUniversità degli Studi di TorinoJournal of Biomedical Practitioners2532-79252023-06-017110.13135/2532-7925/7771Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case reportEleonora Donno0Jessica Di Monte1Manuela Di Mascio2Tiziana Orsini3Annalisa Di Valerio4Luisa Pinti5Paola Massaro6Seila Scardapane7Francesca Fusilli8Franco Salvatore9Amalia Procida10Antonio Esposito11Università degli studi “Gabriele d’Annunzio”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaServizio di Immunoematologia e Medicina Trasfusionale, Ospedale Clinicizzato “SS. Annunziata”, Chieti - ItaUniversità degli studi “Gabriele d’Annunzio”, Chieti - Ita INTRODUCTION This case report traces the diagnostic and therapeutic process of the Immuno-Transfusion Service in a case of fetal anaemia characterized by various inconsistencies between clinical and laboratory data. The paper describes an alternative technique implemented with the aim of resolving incompatibilities between positive IAT and negative DAT. In addition, the algorithm necessary to reach a diagnosis in a transfusion medicine laboratory is traced, namely, the performance of first- and second-level immuno-haematological tests, the evaluation of fetal clinical signs, and the preparation of blood components necessary for intrauterine transfusion. CASE PRESENTATION The case involves a pregnant woman who comes to the Immuno-Transfusion Service following a positive Indirect Antiglobulin Test and fetal anaemia. The main questions relate not only the presence of immunization in the woman, which should have been avoided by immunoprophylaxis (being group 0 Rh negative), but also the stability of the antibody titer (or level) throughout the pregnancy, fetal recovery after TIU, and the presence of a negative Direct Antiglobulin Test. CONCLUSIONS Questions that were completely resolved at caesarean section with the discovery of a giant chorioangioma that, by sequestering fetal red blood cells, caused anaemia and the confirmation of a rare blood phenotype of the father that caused the woman's immunization. https://ojs.unito.it/index.php/jbp/article/view/7771Indirect antiglobulin test (IAT)haemolytic disease of the newbornRh alloimmunizationfetal anaemiagiant chorioangioma
spellingShingle Eleonora Donno
Jessica Di Monte
Manuela Di Mascio
Tiziana Orsini
Annalisa Di Valerio
Luisa Pinti
Paola Massaro
Seila Scardapane
Francesca Fusilli
Franco Salvatore
Amalia Procida
Antonio Esposito
Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
Journal of Biomedical Practitioners
Indirect antiglobulin test (IAT)
haemolytic disease of the newborn
Rh alloimmunization
fetal anaemia
giant chorioangioma
title Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
title_full Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
title_fullStr Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
title_full_unstemmed Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
title_short Usefulness of absorption techniques in doubtful cases of incompatibility Rh maternal fetal: a case report
title_sort usefulness of absorption techniques in doubtful cases of incompatibility rh maternal fetal a case report
topic Indirect antiglobulin test (IAT)
haemolytic disease of the newborn
Rh alloimmunization
fetal anaemia
giant chorioangioma
url https://ojs.unito.it/index.php/jbp/article/view/7771
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