Perinatal transfusion medicine
This chapter discusses transfusion in perinatal medicine. Transfusion management of the pregnant woman and fetus requires special consideration and this chapter address the related issues: routine prenatal and neonatal transfusion testing in relationship to maternal alloimmunization, hemolytic diseases of the fetus and newborn (HDFN) and neonatal alloimmune thrombocytopenia (NAIT) as well as their treatments. HDFN occurs when maternal plasma contains an alloantibody against an antigen carried on the fetal RBCs. The severity of HDFN is influenced by the antibody titer and specificity, the immunoglobulin class and the number of antigenic sites on the RBC. Immune sensitization to RBC antigens occurs after fetomaternal hemorrhage (FMH) during pregnancy or delivery or through previous RBC transfusion. For prenatal testing of HDFN, if the pregnant women is D positive and has no alloantibodies, then no further testing is required. It the pregnant women is D negative and is not sensitized to the D antigen, then she should receive RhIg perinatally.
