ERYTHROBLASTOSIS FOETALIS. A SURVEY OF 491 CONSECUTIVE CASES OF RH-IMMUNIZATION IN PREGNANCY. PART I. STILLBIRTHS DUE TO ERYTHROBLASTOSIS FOETALIS

Abstract

Summary In a survey of consecutive cases of offspring with haemolytic disease born of Rhimmunized women, presumably comprising all cases in 1951–1961 in a region of West Norway, there were 491 children with haemolytic disease; 31 (6.3%) were stillborn and 460 (93.7 %) liveborn. Thirty-one stillbirths occurred in 25 women, 20 with one stillbirth (and one with twins) and five with two stillbirths due to haemolytic disease. Tables show the outcome of all pregnancies in each woman with stillbirths, especially details concerning haemolytic disease in the offspring. The low number of stillbirths in our survey (6.3 %) seen in relation to 16 % in English and American statistics, is thought partly to be due to the low number of pregnancies after the last Rh-immunization ending in stillbirth, but also due to effective induction of labour in Rh-immunized women with bad obstetrical histories in previous pregnancies. In figures details of the incomplete antibody titre in pregnancy, week of gestation of intrauterine death, and the interval between intrauterine death and birth is given in the stillbirths due to e.f. The findings in the stillborn affected with haemolytic disease are also shown, comprising birth weight and length, weight of placenta, hydrops in the stillbirths and post mortem findings. After discussing the observations and referring to the literature, the author suggests a guide to the criteria for inducing labour in Rh-immunized pregnancies.