Large doses of intravenous Rh (D) immunoglobulin lead to sustained elevations in Rh antibody titers

Rhesus (Rh) alloimmunization is potentially devastating for reproductive health. Rarely, RhD mismatched blood may be transfused accidentally, increasing the risks of RhD sensitization. Prevention of Rh sensitization is important especially in women of reproductive age group. Treatment with intravenous RhIg is potentially safe and also the effective means of preventing Rh alloimmunization in cases of Rh-mismatched blood transfusion. We report a case that illustrates the significantly high RhD antibody titers following treatment with intravenous Rh immunoglobulin for prevention of alloimmunization. An 18yo Rh-negative G0 had mistakenly received four units of Rh-positive blood. To avoid future pregnancy related complications, she received monotherapy with 13,200 μg total of intravenous Rh immunoglobulin (RhIg). The treatment was well tolerated; however the RhD antibody titers reached a peak of 1:512. The high levels of RhD antibody titers can have grave implications if the patient is pregnant

Blood glucose control in diet controlled gestational diabetics (GODM A1) following corticosteroid administration

To study the effect of corticosteroids on glucose control in preterm pregnant patients with diet controlled gestational diabetes, and to formulate a plan for surveillance and treatment in order to reduce maternal and neonatal morbidity

Novel mutation in COL1A1 associated with Osteogenesis imperfecta not compatible with life

Osteogenesis imperfecta (OI) is a skeletal dyscrasia characterized by decreased bone strength and associated fractures. Over 95% of autosomal dominant forms of this disease are associated with defects in the genes for collagen COL1A1 and COL1A2.1 The lethal type II disease has been identified antenatally by symmetrically shortened long bones and micromelia. Many reports have indicated that a femur length to abdominal circumference ratio (FL:AC) of less than 0.16 is predictive of lethality associated with OI.2,3 We report a case that presented at 20 weeks’ gestation with shortening of the lower limbs, specifically a lagging femur length and FL:AC of < 0.16. On subsequent ultrasound examinations, progressive shortening of the femur as well as shortening of the long bones of the upper extremities was documented. The thorax appeared normal until 31 weeks. The FL:AC remained below 0.16 throughout pregnancy. Workup in the neonatal period identified a novel mutation in COL1A1. The neonate was able to breathe spontaneously at birth requiring minimal respiratory support for the initial 2 weeks and lived for 26 days

Does observed vs expected lung head ratio correlate with neonatal survival in infants with congenital diaphragmatic hernias?

To investigate whether observed vs expected (O/E) lung–to–head ratio (LHR) correlates with neonatal survival in infants with congenital diaphragmatic hernia (CDH). Secondary goal was to correlate O/E LHR with Oxygenation index (OI) in the first 12 hours of life