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Anti-D is recommended as a first-line therapy for ITP, along with corticosteroids and intravenous immune globulin (IVIG). [ 20 ] [ 22 ] [WinRho SDF is an anti-D manufactured, distributed and marketed by Cangene in the US.
Anti-D immune globulin is usually recommended in those who are Rh-negative. [4] Occasionally, surgery is required. [1] About 30% of women have bleeding in the first trimester (0 to 14 weeks gestational age). [1] [5] Bleeding in the second trimester (12 to 24 weeks gestational age) is less common. [6]
The term "Rh Disease" is commonly used to refer to HDFN due to anti-D antibodies, and prior to the discovery of anti-Rh o (D) immune globulin, it was the most common type of HDFN. The disease ranges from mild to severe, and occurs in the second or subsequent pregnancies of Rh-D negative women when the biologic father is Rh-D positive.
Due to this, there is an increased risk for intrauterine growth retardation, fetal hemorrhage, and maternal hemorrhage within organogenesis and in the second/third trimester. [12] Loperamide has limited data on the impact it has on pregnancy, but there is an association with cardiovascular malformation in the first trimester.
Thus, if the initial titer is 1:4 and stable but increases at 26 weeks' gestation to 1:8, assessment with MCA Doppler velocity at that point is reasonable. However, if the patient presents in the first trimester with a 1:8 titer that remains stable at 1:8 throughout the second trimester, continued serial antibody titers are appropriate.
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Thus, if the initial titer is 1:4 and stable but increases at 26 weeks' gestation to 1:8, assessment with MCA Doppler velocity at that point is reasonable. However, if the patient presents in the first trimester with a 1:8 titer that remains stable at 1:8 throughout the second trimester, continued serial antibody titers are appropriate.