By Santosh Multispeciality Hospital, Gynaecology
In Psychology, Desensitization is generally defined as emotional responsiveness to an aversive, negative, or positive stimulus after repeated exposure. It generally occurs when an emotional response is repeatedly invoked in any situation. However, in medicines, Desensitization is a method to reduce emotional response or negative reaction to a particular stimulus.
During pregnancy, women go through a lot of emotional and psychological changes. They are more sensitive or allergic to certain stimuli during this phase.
The need for desensitizing pregnant women against different allergens has been observed in different studies. Some studies have reported allergies against penicillin, while some others have observed allergic responses to seminal fluid. There are also some studies that have observed the need for desensitizing women against Rh+ blood groups.
Women during pregnancy can be afflicted with various infections like syphilis. These women may need to be administered penicillin as an effective antibiotic against such causative factors.
However, it has been observed that some of these women, who are allergic to penicillin, have had severe outcomes. While some women have suffered from severe immunologic responses, some others have suffered from severe hypotension, resulting in various complications. Such situations call for Desensitization against the causative factor, i.e. Penicillin. In fact, Penicillin Desensitization in such patients has been found to be largely successful. In Penicillin Desensitization, the pregnant woman is administered with increasing dosage of Penicillin, which creates a kind of barrier against severe allergic response against Penicillin.
In Rh negative women, the Rh marker is absent in red blood cells. When these women are transfused with Rh positive blood, a situation called Rh sensitive arises. The immune system reacts to the Rh factor since it does not recognize it. For pregnant women, this equation can get quite complicated. For a pregnant woman with a Rh-negative blood, the fetus can be a Rh positive one. In such cases, especially if the woman is pregnant for the second or third time, the antibodies against the Rh factor may attack the blood of the fetus having a positive Rh factor.
This can lead to a lot of complications in the baby such as jaundice, anemia, etc., and even more serious problems. To avoid such a situation, gynecologists may need to take up Rh Desensitization. Doctors need to ensure in the first trimester of pregnancy that there is no risk of Rh sensitivity occurring during pregnancy. Since there are hardly any symptoms during the first trimester, the gynecologist has to conduct a blood test to confirm it.
Desensitization in Gynecologic Oncologic Patients
Instances of mild to moderate hypersensitive reactions of pregnant women to Carboplatin/Cisplatin in chemotherapy are not uncommon. Such hypersensitivity may be a serious concern both for the mother as well as the fetus. To overcome such sensitivity, gynecologists may need to undertake a Desensitization program against Carboplatin/Cisplatin. Studies have proved that a Desensitization protocol against hypersensitive reactions to Carboplatin and Cisplatin in pregnant women can be quite successful in bringing down the risk of severe outcomes of such hypersensitivity.
Desensitization against specific allergies or hypersensitivities has been found to be quite effective in fighting severe outcomes of such sensitivities. It can save precious lives.