Author/Editor		Rožman, Primož; Urbajs, Matjaž; Bricl, Irena; Majcen-Vivod, Boža
Title		Senzibilizacija RhD: vzroki, posledice in preprečevanje
Translated title		RhD sensibilisation: etiology, consequences and prophylaxis
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 38, št. Suppl 7
Publication year		1999
Volume		str. 37-44
Language		slo
Abstract		RhD sensitisation in a D-negative pregnant woman as an increased risk for a D-positive fetus since the mother's anti-D antibodies cause immune hemolysis of D-positive erythrocytes, thus leading to anemia, hydrops and even fetal death. D-positive newborns suffering from hemolytic disease as a result of their mother's anti-D antibodies are at risk from a high bilirubin concentration that may cause a permanent neurological impairment. In the majority of cases, RhD sensitisation in the mother can be prevented through the consistent implementation of an RhD immunoprophylaxis programme. Anti-D immunoglobulin prevents the mother's primary immune response to D-positive erythrocytes of the child which may reach the mother's bloodstream during childbirth or even during pregnancy. Consistent implementation of RhD immunoprophylaxis can reduce the incidence of primary immunisation after the first pregnancy with a D-positive fetus by over 50 times. In Slovenia RhD immunoprophylaxis programme has started already in 1967. Today we should strive to implement a consistent prophylaxis of D-negative pregnant women with anti-D immunoglobulin. In Slovenia this is currently performed within the framework of the national programme of self-sufficiency with blood products.
Summary		Senzibilizacija RhD pri D-negativni nosečnosti predstavlja povečano tveganje za D-pozitiven plod, ker povzročajo materina protitelesa anti-D imunsko razgradnjo RhD pozitivnih eritrocitov, kar ima lahko za posledico slabokrvnost, hidrops in celo smrt ploda. D-pozitivne novorojenčke s hemolitično boleznijo povzročeno s protitelesi anti-D ogroža visoka koncentracija bilirubina z možnimi trajnimi nevrološkimi okvarami. Senzibilizacijo RhD lahko pri ženskah v večini primerov preprečimo z doslednim izvajanjem programa imunoprofilakse RhD. Imunoglobulin anti-D prepreči primarni imunski odziv na D-pozitivne eritrocite, ki zaidejo v krvni obtok ženske med porodom ali že med nosečnostjo. Dosledno izvajanje imunoprofilakse RhD zmanjša pogosnost primarne imunizacije po prvi nosečnosti z D-pozitivnim plodom za več kot 50-krat. V Sloveniji smo pričeli z izvajanjem imunoprofilakse RhD že leta 1967. Danes si moramo prizadevati za čimbolj dosledno izvajanje zaščite D-negativnih nosečnic z imunoglobulinom anti-D, ki ga v Sloveniji zagotavljamo v okviru programa samozadostnosti s krvnimi proizvodi.
Descriptors		RH ISOIMMUNIZATION RHO(D) IMMUNE GLOBULIN RH-HR BLOOD-GROUP SYSTEM ERYTHROBLASTOSIS, FETAL SLOVENIA