PREGNANCY-BIRTH Messages for May, 2000: Re: Rh sensitized

Re: Rh sensitized

From: Lynn D. Montgomery, MD (anonymous@obgyn.net)
Wed, 31 May 2000 14:33:42 -0500 (CDT)

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In reply to: anonymous@obgyn.net: "Rh sensitized"

At Wed, 31 May 2000, anonymous@obgyn.net wrote:

>After this long history...my questions are:
>
>1) Is is possible for the billirubin levels in the amniotic fluid to
>decrease at this point? For example, could I go back into Zone 1?

Yes, the amount of bilirubin in the amniotic fluid can vary and unless it gets into high zone II or into zone III, it is not indicative of a problem... >
>2) Assuming that the levels don't go past Zone 2, and don't decrease
>into Zone 1, what is the standard treatment? Does the OB induce delivery
>early?

Usually you want to get the baby out when it is safe for the baby from the standpoint of being free of any prematurity risks... >
>3) Are there any questions or concerns that I should be bringing up with
>my perinatologist about the treatment? The amnios started at 24 weeks,
>and I have a feeling that they will continue roughly every 2 weeks until
>I deliver. I understand that we have to wait for the results of the
>next test to determine what the course of action is, but I am interested
>in the basic treatment at this point.

Basically, the results of the aminocentesis each time will determine the future route of testing and/or therapy. As long as the fluid remains in the lower 2/3 of zone II or lower, the baby is fine. If you want to ask a good question, ask about using middle cerebral artery velocity to assess for fetal anemia rather than doing serial amnios (article in New England Journal of Medicine, January 6th, 2000 by G. Mari) >
>My peri doesn't think that this pregnancy will go to the point of
>needing intrauterine blood transfusions. Will the baby need blood
>transfusions after birth?

There is always a possibility of the baby requiring a transfusion following delivery and because of that, the baby's pediatrician will follow his/her blood counts in the nursery and after...

--
Lynn D. Montgomery, MD
Director, Maternal-Fetal Medicine
Rocky Mountain Perinatal Center
Missoula, Montana

**Note:  Opinions expressed here are for educational purposes only and, as such, do not constitute a physician-patient relationship.  This information is not intended to supplant the need for you to consult with your physician prior to choosing therapeutic options and/or interventions.

**Private e-mails cannot be entertained due to time constraints, consequently no private e-mails will receive a response.

**Thank you for your understanding ;-)

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In reply to: anonymous@obgyn.net: "Rh sensitized"

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