In the offered case MCA Doppler measurement showed that this PSV was critically high level; however, before further screening could be performed the patient was delivered prematurely due to fetal distress. isoimmunization. The baby was successfully treated with exchange transfusion of Kellnegative packed reddish cells, and was discharged on postnatal d 30. Conclusion: The offered case of hydrops fetalis was due Kell alloimmunization that was detected during the postnatal period, and thus we plan to discuss the perinatal approach to Kell immunization. strong class=”kwd-title” Keywords: Hydrops fetalis, Anemia, Kell alloimmunization, newborn Abstract Ama?: Gnmzde Rhesus (Rh) immunoglobulinin yayg?n olarak uygulanmas? RhD alloimmnizasyon insidans?nda azalmaya neden olurken RhD d???ndaki eritrosit antijenleri ile maternal alloimmunizasyon perinatal morbidite ve mortaliteye yol a?maya devam etmektedir. Kell antijeni toplumda yaln?zca %9 oran?nda bulunmas?na ra?men bu antijene ba?l? alloimmunizasyon gnmzde ?n plana ??kmaya ba?lam??t?r. Olgu Sunumu: Hastam?z 30. gebelik haftas?nda antenatal fetal hidrops tan?s? alm??t?. Fetal durumu de?erlendirmeye y?nelik antenatal testler kritik dzeyde hemolitik hastal??? g?sterdi, ancak hasta fetal distres nedeniyle prematre olarak do?urtuldu. Anemi, retiklositopeni, hidrops fetalis ve pozitif indirekt Coombs testi Kell izoimmunizasyonunu d?ndrd. Postnatal d?nemde Kell-negatif eritrosit sspansiyonu ile kan de?i?imi uygulanan hasta postnatal 30.gn ?ifa ile taburcu edildi. Sonu?: Bu makalede, Kell izoimmunizasyonuna ba?l? geli?ti?ini postnatal d?nemde saptad???m?z bir hidrops fetalis olgusu sunularak Kell immunizasyonuna perinatal yakla??m?n tart???lmas? planland?. Bu durum fetusun antijen negatif uygun kan ile ba?ar?l? bir ?ekilde tedavi edilmesine olanak sa?layacakt?r. INTRODUCTION Hydrops fetalis is the excessive accumulation of fluid in the A-395 subcutaneous tissues and serous cavities of A-395 fetuses and neonates. The first cases described were associated with Rhesus (Rh) alloimmunization. While routine administration of Rh immunoglobulin has significantly reduced the incidence of this type of alloimmunization, maternal alloimmunization to other reddish cell antigens remains a contributor to perinatal morbidity and mortality. Even though Kell antigen is seen on the reddish cells of only 9% of the general population, attention to Kell antibodies continues to increase. As a possible factor associated with fetal anemia in the case of Kell alloimmunization is usually suppression of erythropoiesis, reticulocyte and normoblast counts are inappropriately low for the degree of fetal anemia in fetuses and neonates. Herein we describe a preterm neonate with hydrops fetalis due to Kell isoimmunization that was detected during the postnatal period, and discuss the perinatal approach to this rare condition. CASE REPORTS A male neonate was delivered via cesarean section after 32 weeks and 5 days of gestation to a 24-year-old gravida 3, para 2 mother. The patients 1st and 5th min APGAR scores were 3 and 6, respectively. The newborn required intubation and ventilation support due to respiratory distress that developed A-395 after immediately following birth and was admitted to the neonatal rigorous care unit. Program ultrasonographic examination at 30 weeks of gestation showed fetal ascites and cardiomegaly, and fetal echocardiography confirmed myocardial hypertrophy. Doppler measurement of the middle cerebral artery (MCA) was performed for the prediction of fetal anemia and the peak systolic velocity (PSV) was significantly elevated (60 cm sC1). Several tests were performed to determine the etiology of the fetal anemia during the pregnancy. The mothers blood group was AB Rh(+); therefore, Rh and ABO incompatibility were eliminated as the cause of hydrops. IgM antibody against parvovirus B19 (the etiological agent of anemia) was unfavorable. The mothers obstetric history included normal full-term delivery of a healthy male 4 years earlier, and dilation and curettage (D&C) two years ago. The mother had by no means received a blood transfusion; her and her familys medical history were normally unremarkable. Physical examination of the neonate neonate immediately following Rabbit Polyclonal to Cytochrome P450 19A1 birth showed noticeable pallor and gross skin edema. He weighed 2600 g, his respiratory rate was 72 breaths minC1 with retractions, and vesicular breath sounds were audible. A grade 2/6 systolic murmur was heard and abdominal distention was noted due to massive ascites. The liver and spleen were palpable 2 cm and 1 cm below the costal margins,.
