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Isoimmunization occurs when the maternal immune system is sensitized to red blood cell surface antigens. The most common causes of isoimmunization are blood transfusion, and fetal-maternal hemorrhage. [12] The hemolytic process can result in anemia, hyperbilirubinemia, neonatal thrombocytopenia, and neonatal neutropenia. [6]
Miscarriage, also known in medical terms as a spontaneous abortion, is an end to pregnancy resulting in the loss and expulsion of an embryo or fetus from the womb before it can survive independently. [ 1 ] [ 4 ] Miscarriage before 6 weeks of gestation is defined as biochemical loss by ESHRE .
Immune tolerance in pregnancy or maternal immune tolerance is the immune tolerance shown towards the fetus and placenta during pregnancy. This tolerance counters the immune response that would normally result in the rejection of something foreign in the body, as can happen in cases of spontaneous abortion .
A stillbirth can often result in the feeling of guilt or grief in the mother. [10] The term is in contrast to miscarriage, which is an early pregnancy loss, [11] and sudden infant death syndrome, where the baby dies a short time after being born alive. [10] Often the cause is unknown.
Early stillbirth is between 20 and 27 weeks gestation, while late stillbirth is between 28 and 36 weeks gestation. A term stillbirth is when the fetus dies 37 weeks and above. [47] This phenomenon can go beyond grief and can lead to worries about strange maternal feelings or postpartum treatment regarding complications of childbirth. [48]
This is a major cause of HDN, because 75% of pregnancies result in some contact between fetal and maternal blood, and 15–50% of pregnancies have hemorrhages with the potential for immune sensitization. The amount of fetal blood needed to cause maternal sensitization depends on the individual's immune system and ranges from 0.1 mL to 30 mL. [5]
A normal pregnancy contains higher numbers of immune cells, however, in a normal pregnancy, the immune system does not attack the fetus, but works to protect it as it grows and divides at an incredibly fast rate. T helper cells, Th1 and Th2, differ based on cytokine levels; Th1 is up-regulated during pregnancy,whereas Th2 is up-regulated in cancer.
Bleeding which occurs before 24 weeks is known as early pregnancy bleeding. Causes of bleeding before and during childbirth include cervicitis, placenta previa, placental abruption and uterine rupture. [4] [5] Causes of bleeding after childbirth include poor contraction of the uterus, retained products of conception, and bleeding disorders. [4]