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IsoimmunitationFrom: José Manuel Torreblanca Doblas (jmtd@inicia.es)Fri Apr 26 16:16:48 2002
Dear colleagues, this is a case of Rh-isoimmunitation. I´m working at a Spanish town in North Africa bordering Morocco. Spanish laws permit the care of a foreign pregnant whenever she´s into national territory. So, we have to attend a lot of no controlled pregnancies (high risk), with varied pathology. I present a rare case of Rh isoimmunitation, fortunately not very seen nowadays. G3P3: 1st. normal delivery, alive and healthy; 2nd, death a few hours after vaginal delivery; 3rd, stillborn, vaginal delivery. Rh (-). Current gestation controlled by a private obgyn. 33 wk in her first visit to my office. Indirect Coombs from 1/32 to 1/64 in one week. I perform an abdominal scan and observe: - oedema scalp. - right heart failure with discharge in pericardium, and increase of right cavities and vessels (superior cava). - important ascitis with increase of abdominal perimeter, and liver and intestinal handles floating in it. This image occupied all the u.s. display. Amniotic fluid "normal". Placenta II/IV. I have pics of head, and abdomen, that will send you in the next messages. This case is interesting because we cannot see it often. This patient was sent to a 4th level hospital.
-- José M. Torreblanca Doblas Ob/Gyn Ph Hospital Comarcal de Melilla Spain http://medpages.obgyn.net/torreblanca
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