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Fatemeh Golshahi, Speaker at Neonatology Conferences
Tehran University of Medical Sciences, Iran (Islamic Republic of)

Abstract:

Fetal hemolysis is caused by maternal antibodies that cross the placenta. Anti-M antibodies can rarely cause severe forms of alloimmunization in the fetus and newborn. We present a case of severe anti-M alloimmunization requiring a total of 8 intrauterine transfusions, in a patient with a prior poor obstetrical history.
A 35-year-old Iranian pregnant woman with a prior obstetrical history of one abortion and two stillbirths was found to have had anti-M antibody titers 1:8 and accompanying elevated middle cerebral artery peak systolic velocity (MCA-PSV) of 1.9 MoM suggestive of severe fetal anemia at 17 weeks of gestation. Persistently elevated fetal MCA-PSV was noted despite intraperitoneal transfusion at 17, 19, and 22 weeks. Fetal blood sampling at 27 weeks confirmed severe fetal anemia (3 g/dL), which required additional intravascular and intraperitoneal blood transfusion.
 At 37 weeks, elective cesarean section was performed. Neonatal hemoglobin immediately after delivery was 10.1 g/dL. In addition to standard supportive care, the neonate required two additional transfusions and remained in the neonatal intensive care unit (NICU) for 23 days. Anti-M antibodies are a rare cause of severe alloimmunization. We present a case in order to improve management.

Biography:

Dr. Fatemeh Golshahi completed her fellowship in Maternal-Fetal Medicine in 2017 at Tehran University of Medical Sciences, Iran. She currently serves as an Associate Professor at Tehran Medical University. With over 60 publications to her name, Dr. Golshahi's work has been extensively cited, reflecting her significant contributions to the field. Her institution is recognized as a referral center for fetal surgery and invasive procedures as intrauterine transfusions for fetal anemia in Iran, and she plays a pivotal role in training numerous OBGYN residents and maternal fetal medicine fellows annually.

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