20 KB69 KB19 KB192920262003Bricl, IrenaOgrizek-Pelkič, KsenijaVogler, Andrejštevilka:12letnik:72str. 671-673ISSN:1318-0347COBISSID:17389785URN:URN:NBN:SI:doc-PRKWHC5DslSlovensko zdravniško društvoZdravniški vestnikBlood Grouping And CrossmatchingBlood Transfusion, IntrauterineCoombs' TestCoombsov testEritroblastoza plodaErythroblastosis, FetalExchange Transfusion, Whole Bloodhuman pregnancyimunizacijaimunologijaIzmenjalna transfuzija celotne krviKrvna transfuzija intrauterinaKrvne skupine in navzkrižno določanjeNosečnostporodništvoPregnancyprotitelesaRh IsoimmunizationRh izoimunizacijaHemolitična bolezen ploda in novorojenčka (HBPN) - prikaz primera| Haemolytic disease of the fetus and newborn (HDNF) - case reprt|Background. Hemolytic disease of the fetus and newborn (HDFN) develops becauseof the passage of maternal erythrocyte alloantibodies through the placenta. These antibodies cause a reduction of the erythrocyte life span in the fetus and newborn. This severe form of the disease is most commonly causedby anti-D antibodies. Besides those, the hemolytic disease can also be caused by anti-K, anti-c, anti-E, anti A, anti-B and some other antibodies. Methods and material. A case of a pregnant woman who has been pregnant four times is presented. During the first pregnancy, she developed anti-D erythrocyte antibodies, and after the third pregnancy also additional anti-C antibodies. During the first pregnancy, hemolytic disease of fetus led to the intrauterine death of the fetus. The second child died one day after birth. The third and fourth fetuses required several intrauterine exchange transfusions due to high titers and great hemolytic activity of anti-D antibodies. In both newborns, exchange transfusions had to be performed after birth, and both received additional transfusions of concentrated erythrocytes because of anemia. Conclusions. HDFN is a severe disorder that can be successfully prevented with appropriate legalized measuresIzhodišča. Hemolitična bolezen ploda in novorojenčka (HBPN) nastane zaradi prenosa materinih eritrocitnih aloprotiteles skozi posteljico, ki povzročijo skrajšanje živjenjske dobe plodovih oziroma novorojenčkovih eritrocitov. Za hudo obliko bolezni so najpogosteje odgovorna protitelesa anti-D. HBPN lahko povzročijo tudi protitelesa anti-K, anti-c, anti-E, anti A, anti-B in še nekatera druga. Bolniki in metode. Predstavljena je nosečnica, ki je bila štirikrat noseča. Med prvo nosečnostjo je razvila eritrocitna protitelesa anti-D, po tretjem porodu pa še protitelesa anti-c. Med prvo nosečnostjo je prišlo zaradi hemolitične bolezni ploda do smrti ploda v maternici, drugi otrok je umrl dan po rojstvu. Tretjemu in četrtemu plodu je bilo potrebno zaradi visokega titra in agresivnosti protiteles anti-D dati več intrauterinihizmenjalnih transfuzij. Pri obeh novorojenčkih je bilo potrebno tudi po porodu opraviti izmenjalne transfuzije. Oba sta po rojstvu zaradi anemije še dodatno prejela koncentrirane eritrocite. Zaključki. HBPN je huda bolezen z visoko obolevnostjo in umrjivostjo kljub najsodobnejšim možnostim zdravljenja, ki pa jo lahko preprečimo z doslednim izvajanjem ustreznih preventivnih ukrepov, ki so tudi uzakonjeniTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo