Premature Restriction of Foramen Ovale in an Anemic Fetus From a Rhesus-negative Mother: A Case Report

IF 0.8 Q4 REPRODUCTIVE BIOLOGY
H. Vafaei, N. Asadi, Ali Mohammad Shakibafard, M. Kasraeian, Neda Rahimirad, Shaghayegh Moradi Alamdarloo, Shohreh Roozmeh, K. Hessami
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引用次数: 0

Abstract

Rhesus (Rh) negative women who are exposed to Rhpositive red blood cells (RBCs) (e.g., those who deliver a D-positive baby) are at the risk of developing anti-D antibodies against the Rh antigens present on the surface of RBCs. Memory response of maternal immune system in subsequent re-exposures makes Ig G antibody which is transferred across the placenta into the fetal circulation. Rh-positive fetuses from these mothers are at the risk of serious morbidity and mortality, and a group of disorders such as severe hemolytic anemia, hydrops fetalis, and intrauterine fetal demise if not treated. The fetal middle cerebral artery-peak systolic velocity (MCA-PSV) is a noninvasive tool for the diagnosis of fetal anemia. The sensitivity of MCA-PSV> 1.5 MoM (multiples of the median) is 100% for the prediction of moderate or severe anemia in the fetuses never transfused with a false positive rate of 12% (1). During intrauterine life, foramen ovale (FO) is the only pathway for the oxygenated maternal blood to enter from the right atrium of the heart to the left one and then being pumped into the upper part of fetus’s body (2). Premature closure or restriction of the FO is a rare and serious clinical condition that prevents this normal fetal blood circulation. It can be associated with fetal arrhythmia, right -side heart failure, pericardial effusion, tricuspid regurgitation (TR), non-immune hydrops fetalis, and intrauterine fetal death with unknown causes during the pregnancy (3,4). Premature restriction of FO is diagnosed based on the following criteria (5): • An FO diameter <3 mm with a Doppler velocity measured gradient >5 mm Hg or • FO diameter <2 mm with Doppler velocity >120 cm/s In this study, a case of premature restriction of FO was described in a fetus from the RH alloimmunizated mother who had severe intrauterine hemolytic anemia not detected antepartum by routine Doppler ultrasound examination of MCA-PSV-MoM..
恒河阴性母亲致贫血胎儿卵圆孔过早受限1例
Rh阴性妇女暴露于Rh阳性红细胞(rbc)(例如,生下d阳性婴儿的妇女)有产生抗d抗体的风险,这种抗体针对存在于红细胞表面的Rh抗原。母体免疫系统在随后的再暴露中的记忆反应使igg抗体通过胎盘转移到胎儿循环中。来自这些母亲的rh阳性胎儿如果不进行治疗,将面临严重发病率和死亡率以及严重溶血性贫血、胎儿水肿和宫内胎儿死亡等一系列疾病的风险。胎儿大脑中动脉收缩峰值速度(MCA-PSV)是一种诊断胎儿贫血的无创工具。MCA-PSV> 1.5 MoM(中位数的倍数)对于预测从未输血的胎儿中度或重度贫血的敏感性为100%,假阳性率为12%(1)。卵圆孔(foo)是含氧母体血液从右心房进入左心房并被泵入胎儿身体上部的唯一途径(2)。过早关闭或限制foo是一种罕见而严重的临床疾病,它阻碍了胎儿正常的血液循环。它可与妊娠期间胎儿心律失常、右侧心力衰竭、心包积液、三尖瓣反流(TR)、非免疫性胎儿水肿和不明原因的宫内胎儿死亡相关(3,4)。FO过早受限的诊断依据如下标准(5):•FO直径5 mm Hg或•FO直径120 cm/s。本研究报告1例来自RH同种异体免疫母亲的胎儿,其患有严重的宫内溶血性贫血,产前常规多普勒超声检查MCA-PSV-MoM未发现。
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来源期刊
CiteScore
1.60
自引率
14.30%
发文量
8
期刊介绍: All kind of knowledge contributing to the development of science by its content, value, level and originality will be covered by IJWHR. Problems of public health and their solutions are at the head of the windows opening us to the world. The "International Journal of Women''s Health and Reproduction Sciences” is a modern forum for scientific communication, covering all aspects women health and reproduction sciences, in basic and clinical sciences, mainly including: -Medical Education in Women Health and Reproduction Sciences -Cardiology in Women Health-Related Reproductive Problems -Sports Medicine in Women Health and Reproduction Sciences -Psychiatry in Women Health-Related Reproductive Problems -Antioxidant Therapy in Reproduction Medicine Sciences -Nutrition in Women Health and Reproduction Sciences -Defense Androgen and Estrogen -Fertility and Infertility -Urogynecology -Endometriosis -Endocrinology -Breast Cancer -Menopause -Puberty -Eroticism -Pregnancy -Preterm Birth -Vaginal Diseases -Sex-Based Biology -Surgical Procedures -Nursing in Pregnancy -Obstetrics/Gynecology -Polycystic Ovary Syndrome -Hyperandrogenism in Females -Menstrual Syndrome and Complications -Oncology of Female Reproductive Organs -Traditional Medicine in Women Reproductive Health -Ultrasound in Women Health Reproduction sciences -Stem Cell Research In Women Reproduction Sciences -Complementary Medicine in Women Reproductive Health -Female Sexual Dysfunction: Pathophysiology & Treatment
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