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Correlation of maternal serum and amniotic fluid bilirubin in gravid patients with sickle cell anemia who were actively hemolyzing

  • Arthur T. Fort
    Footnotes
    Affiliations
    University of Tennessee College of Medicine, Department of Obstetrics-Gynecology, Memphis, Tennessee, USA

    the Clinical Research Center of the University of Tennessee Memphis, Tennessee, USA
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  • John C. Morrison
    Affiliations
    University of Tennessee College of Medicine, Department of Obstetrics-Gynecology, Memphis, Tennessee, USA

    the Clinical Research Center of the University of Tennessee Memphis, Tennessee, USA
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  • J.B. Ragland
    Affiliations
    University of Tennessee College of Medicine, Department of Obstetrics-Gynecology, Memphis, Tennessee, USA

    the Clinical Research Center of the University of Tennessee Memphis, Tennessee, USA
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  • B.S. Morgan
    Affiliations
    University of Tennessee College of Medicine, Department of Obstetrics-Gynecology, Memphis, Tennessee, USA

    the Clinical Research Center of the University of Tennessee Memphis, Tennessee, USA
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  • Stewart A. Fish
    Correspondence
    Reprint requests: Dr. Fish, Department of Obstetrics and Gynecology, University of Tennessee College of Medicine, 894 Madison Ave., Memphis, Tennessee 38103
    Affiliations
    University of Tennessee College of Medicine, Department of Obstetrics-Gynecology, Memphis, Tennessee, USA

    the Clinical Research Center of the University of Tennessee Memphis, Tennessee, USA
    Search for articles by this author
  • Author Footnotes
    ∗ Present address: Department of Obstetrics and Gynecology, Louisiana State University School of Medicine at Shreveport, 501 East Stoner, Shreveport, Louisiana.
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      Abstract

      Seven patients with homozygous sickle cell anemia in pregnancy were observed. Simultaneous amniotic fluid biliscan and maternal serum bilirubin values were determined at various intervals from 20 weeks until delivery. The elevation of the biliscan into Zone III (Liley's nomogram) followed the rise in maternal serum bilirubin closely and was related to the time of maternal crisis regardless of time of gestation or labor and delivery. The infants were not affected by the elevated bilirubin, did not contribuse to its elevation, and were found to have normal cord bilirubin levels at birth. Therefore, the findings of a Zone III Liley curve in late pregnancy alone should not prejudice one into performing an unneaessary premature delivery in patients with sickle cell anemia.
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