{"?xml":{"@version":"1.0"},"edm:RDF":{"@xmlns:dc":"http://purl.org/dc/elements/1.1/","@xmlns:edm":"http://www.europeana.eu/schemas/edm/","@xmlns:wgs84_pos":"http://www.w3.org/2003/01/geo/wgs84_pos","@xmlns:foaf":"http://xmlns.com/foaf/0.1/","@xmlns:rdaGr2":"http://rdvocab.info/ElementsGr2","@xmlns:oai":"http://www.openarchives.org/OAI/2.0/","@xmlns:owl":"http://www.w3.org/2002/07/owl#","@xmlns:rdf":"http://www.w3.org/1999/02/22-rdf-syntax-ns#","@xmlns:ore":"http://www.openarchives.org/ore/terms/","@xmlns:skos":"http://www.w3.org/2004/02/skos/core#","@xmlns:dcterms":"http://purl.org/dc/terms/","edm:WebResource":[{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-LBJF4I4U/8cb35876-415c-449b-8d94-560fb80ee28d/PDF","dcterms:extent":"244 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-LBJF4I4U/c81a9195-a8ff-4a16-972a-1782007fae64/TEXT","dcterms:extent":"46 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-LBJF4I4U/19115697-ddc9-4ed1-b441-6970d2b09c0f/PDF","dcterms:extent":"238 KB"},{"@rdf:about":"http://www.dlib.si/stream/URN:NBN:SI:doc-LBJF4I4U/df4da560-ba06-4714-a57e-85deb631e0da/TEXT","dcterms:extent":"48 KB"}],"edm:TimeSpan":{"@rdf:about":"1929-2026","edm:begin":{"@xml:lang":"en","#text":"1929"},"edm:end":{"@xml:lang":"en","#text":"2026"}},"edm:ProvidedCHO":{"@rdf:about":"URN:NBN:SI:doc-LBJF4I4U","dcterms:isPartOf":[{"@rdf:resource":"https://www.dlib.si/details/urn:nbn:si:spr-a30mfzkp"},{"@xml:lang":"sl","#text":"Zdravniški vestnik"}],"dcterms:issued":"2022","dc:creator":["Bricl, Irena","Lehner, Natalija","Mrak, Janja"],"dc:contributor":"Mrak, Janja","dc:format":[{"@xml:lang":"sl","#text":"453-461 str."},{"@xml:lang":"sl","#text":"letnik:91"},{"@xml:lang":"sl","#text":"številka:iss. 11-12"}],"dc:identifier":["DOI:10.6016/ZdravVestn.3276","ISSN:1318-0347","COBISSID_HOST:140653827","URN:URN:NBN:SI:doc-LBJF4I4U"],"dc:language":"sl","dc:publisher":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"dc:subject":[{"@xml:lang":"en","#text":"immunising events"},{"@xml:lang":"en","#text":"immunoglobuline anti-D"},{"@xml:lang":"sl","#text":"imunizirajoči dogodki"},{"@xml:lang":"sl","#text":"imunoglobulin anti-D"},{"@xml:lang":"en","#text":"preventive inoculation"},{"@xml:lang":"sl","#text":"preventivno vbrizganje"},{"@xml:lang":"sl","#text":"RhD"}],"dcterms:temporal":{"@rdf:resource":"1929-2026"},"dc:title":{"@xml:lang":"sl","#text":"Perinatalna zaščita z imunoglobulinom anti-D in vpliv senzibilizacije na antigen RhD med nosečnicami v Sloveniji| Perinatal prophylaxis with immunoglobulin anti-D and the impact on RhD sensitizations among pregnant women in Slovenia|"},"dc:description":[{"@xml:lang":"sl","#text":"Background: Sensitizations to red blood cell antigens may be a relevant cause of foetal and neonatal- perinatal morbidity. Of all red blood cell antigens, only alloantibodies to antigen RhD (D) can be prevented during pregnancy using perinatal preventive inoculation with anti-D immunoglobulin (Ig anti-D). Nevertheless, new sensitizations to antigen D among preg-nant women are detected. The purpose of this article is to determine the incidence of sensitizations to antigen D among pregnant women in Slovenia in the period from 1 January 2010 to 31 December 2020 and to identify the most likely causes for sensitizations.Methods: We retrospectively reviewed the medical records and the laboratory data in the transfusion information system for pregnant women, in whom we detected antibodies anti-D for the first time, from 1 January 2010 to 31 December 2020. We identified the most likely causes of sensitisation to anti-D from the data. The research was conducted at the Blood Transfusion Centre of Slovenia in Ljubljana (ZTM) and the Centre for Transfusion Medicine at the University Medical Centre Maribor (CTM).Results: We detected 69 new sensitizations to D antigen in the reviewed period, which means that 0.16% of D-negative (D-neg) pregnant women or 0.26% D-neg pregnant women at risk were sensitized. 45% of sensitizations occurred during pregnancy, 29% after childbirth of a D-positive (D-poz) child, 9% after previous abortion. Of the 45% sensitizations during pregnancy, 8 cases (26%) could be prevented, 1 case (3%) could not be prevented, other cases (71%) have most likely oc-curred as a result of silent foetomaternal haemorrhage (FMK). Of the 38% of sensitizations that occurred after a previous birth or abortion, 4 cases (15%) could be prevented; 2 cases after abortion, 1 case after childbirth abroad, 1 case of refused protection. We could prevent 12 cases (17.5%) of all sensitizations that most likely occurred due to incomplete compliance with the guidelines for preventive inoculation with Ig anti-D (in 2 cases (3%) pregnant women refused protection), 1 case (1.5%) could not be prevented (the pregnant woman did not come to the gynaecologist despite the bleeding).Conclusion: More than 80% of sensitizations occurred despite following guidelines for their prevention; 12 cases (17.5%) could be prevented (7 cases of incomplete perinatal inoculation with Ig anti-D, 1 case of missed postpartum protection and 2 after abortion, 2 cases of refused protection), one case (1.5%) could not be prevented (one pregnant woman did not visit a gynaecologist despite the bleeding). A new measure to prevent sensitization could be routine protection with Ig anti-D in the second trimester of pregnancy and additional educational programs before planning a pregnancy. These programmes should pay particular attention to identifying and responding to potential sensitizing events in pregnancy, blood type D, and the consequences of refusing inoculation with Ig anti-D. Targeted protection represents one of the measures in this area"},{"@xml:lang":"sl","#text":"Izhodišča: Senzibilizacije na eritrocitne antigene so lahko pomemben vzrok perinatalne obolevnosti plodov in novoro-jenčkov. Od vseh eritrocitnih antigenov lahko med nosečnostjo preprečujemo nastanek aloprotiteles le proti antigenu RhD (D), in sicer s perinatalnim preventivnim vbrizganjem imunoglobulina anti-D (Ig anti-D). Kljub temu odkrivamo med noseč-nicami nove senzibilizacije na antigen D. Namen članka je določiti incidenco senzibilizacij na antigen D med nosečnicami v Sloveniji v obdobju od 1. 1. 2010 do 31. 12. 2020 ter prepoznati najverjetnejše vzroke za njihov nastanek. Metode: Retrospektivno smo pregledali medicinsko dokumentacijo z anamnestičnimi podatki in izvide laboratorijskih preiskav v transfuzijskem informacijskem sistemu za nosečnice, pri katerih smo v izbranem obdobju prvič odkrili proti-telesa anti-D. Iz dokumentacije smo razbrali najverjetnejše vzroke za nastanek anti-D. Raziskava je potekala na Zavodu RS za transfuzijsko medicino v Ljubljani (ZTM) ter na Centru za transfuzijsko medicino v Univerzitetnem kliničnem centru Maribor (CTM). Rezultati: V obravnavanem obdobju smo odkrili 69 novih senzibilizacij na antigen D, kar pomeni, da se je senzibiliziralo 0,16 % D-negativnih (D-neg) nosečnic oz. 0,26 % D-neg nosečnic s tveganjem. Med nosečnostjo je nastalo 45 % senzibili-zacij, 29 % po rojstvu D-pozitivnega (D-poz) otroka, 9 % po predhodni prekinitvi nosečnosti. Od 45 % senzibilizacij med nosečnostjo bi lahko preprečili 8 primerov (26 %), 1 primera (3 %) nismo mogli preprečiti, ostali primeri (71 %) pa so naj-verjetneje posledica tihih fetomaternalnih krvavitev (FMK). Od 38 % senzibilizacij, ki so nastale po predhodnem porodu ali prekinitvi nosečnosti, bi lahko preprečili 4 primere (15 %): 2 primera po prekinitvi nosečnosti, 1 primer po rojstvu D-poz otroka v tujini, 1 primer zavrnitve zaščite. Skupno bi lahko preprečili 12 senzibilizacij (17,5 %), ki so najverjetneje posledica nepopolnega upoštevanja smernic za preventivno vbrizganje Ig anti-D (med njimi sta 2 nosečnici (3 %) zaščito zavrnili), enega primera (1,5 %) nismo mogli preprečiti (nosečnica kljub krvavitvi ni prišla h ginekologu).Zaključek: Več kot 80 % senzibilizacij je nastalo kljub upoštevanju smernic za njihovo preprečevanje, 12 primerov (17,5 %) bi lahko preprečili (7 primerov nepopolne perinatalne zaščite z Ig anti-D, 1 primer neizvedene zaščite po rojstvu D-poz ot-roka in 2 po prekinitvi nosečnosti, 2 primera zavrnjene zaščite), enega primera (1,5 %) pa kljub upoštevanju smernic nismo mogli preprečiti, ker nosečnica kljub krvavitvi ni obiskala ginekologa. Novi ukrep za preprečevanje senzibilizacij bi lahko bila rutinska zaščita z Ig anti-D še v drugem trimesečju nosečnosti in dodatni izobraževalni programi pred načrtovanjem nosečnosti. Posebno pozornost bi bilo potrebno nameniti prepoznavanju in ukrepanju ob možnih dogodkih, ko lahko pride do senzibiliziranja v nosečnosti, krvni skupini D ter ob posledicah zavrnitve zaščite z Ig anti-D. Ciljana zaščita že pred-stavlja enega od ukrepov na tem področju"}],"edm:type":"TEXT","dc:type":[{"@xml:lang":"sl","#text":"znanstveno časopisje"},{"@xml:lang":"en","#text":"journals"},{"@rdf:resource":"http://www.wikidata.org/entity/Q361785"}]},"ore:Aggregation":{"@rdf:about":"http://www.dlib.si/?URN=URN:NBN:SI:doc-LBJF4I4U","edm:aggregatedCHO":{"@rdf:resource":"URN:NBN:SI:doc-LBJF4I4U"},"edm:isShownBy":{"@rdf:resource":"http://www.dlib.si/stream/URN:NBN:SI:doc-LBJF4I4U/8cb35876-415c-449b-8d94-560fb80ee28d/PDF"},"edm:rights":{"@rdf:resource":"http://creativecommons.org/licenses/by-nc/4.0/"},"edm:provider":"Slovenian National E-content Aggregator","edm:intermediateProvider":{"@xml:lang":"en","#text":"National and University Library of Slovenia"},"edm:dataProvider":{"@xml:lang":"sl","#text":"Slovensko zdravniško društvo"},"edm:object":{"@rdf:resource":"http://www.dlib.si/streamdb/URN:NBN:SI:doc-LBJF4I4U/maxi/edm"},"edm:isShownAt":{"@rdf:resource":"http://www.dlib.si/details/URN:NBN:SI:doc-LBJF4I4U"}}}}