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OBJECTIVE:To review cases of anti -c isoimmunization and determine the most appropriate management strategies.METHODS:We performed a review of 102pregnancies managed at The Ohio State University from 1967to 2001for anti -c isoimmunization.Of these,55had complete data and are included in this report.Information collected included serum titers,△OD 450 values,Liley zones,fetal and neonatal hemoglobin levels and a ntigen typing,neonatal direct antiglobulin test,and neonatal outcomes.The appropriateness of traditional management was then e-valuated.RESULTS:Of the 55pregnan cies,46had fe-tuses with positive direct antiglob ulin test,and nine preg-nancies had unaffected fetuses.Of t he affected neonates,12(26%)had serious hemolytic disease of the newborn.Of these 12,8required fetal transfu sion,and the remain-ing 4newborns had hemoglobin levels of less than 10g /dL at the time of delivery.A titer of 1:32or greater or the presence of hydrops fetalis identified all such fetuses.There were 58amniocenteses perform ed for△OD 450 .When plotted on modified Liley graph s,△OD 450 values corresponded to disease severity.T here were no perinatal deaths attributable to anti -c hemolytic disease of the newborn.CONCLUSION:Anti -c isoimm unization might cause significant fetal and newborn hemolytic disease.A titer of 1:32or greater or evidence o f hydrops fetalis i-dentified all the serious hemolytic disease at our institu-tion.The significance of antibody t iters and△OD 450 values was similar to Rh -D sensitize d pregnancies,and management by the same modalities is appropriate.
OBJECTIVE: To review cases of anti-c isoimmunization and determine the most appropriate management strategies. METHODS: We performed a review of 102 pregnancies managed at The Ohio State University from 1967 to 2001 for anti-c isoimmunization. These, 55had complete data and are included in this report.Information collected included serum titers, OD 450 values, Liley zones, fetal and neonatal hemoglobin levels and a ntigen typing, neonatal direct antiglobulin test, and neonatal outcomes.The appropriateness of traditional management was then e-valuated .RESULTS: Of the 55pregnan cies, 46had fe-tuses with positive direct antiglob ulin test, and nine preg-nancies had unaffected fetuses. Of t he affected neonates, 12 (26%) had serious hemolytic disease of the newborn. Of these 12,8required fetal transfuses sion, and the remain-ing 4newborns had hemoglobin levels of less than 10g / dL at the time of delivery. A titer of 1: 32or greater or the presence of hydrops fetalis identified all such fetuses.There were 58a mniocenteses perform ed for? OD 450.When plotted on modified Liley graph s,? OD 450 values are corresponded to disease severity. Here are no perinatal deaths attributable to anti-c hemolytic disease of the newborn. CONCLUSION: Anti-c isoimm unization might cause significant fetal and newborn hemolytic disease. A titer of 1: 32 greater or evidence of hydrops fetalis i-dentified all the serious hemolytic disease at our institu- tion. the significance of antibody t iters and Δ OD 450 values was similar to Rh- D sensitize d pregnancies, and management by the same modalities are appropriate.