Beate Mayer1, Larry Hinkson2, Wiebke Hillebrand2, Wolfgang Henrich2, Abdulgabar Salama3. 1. Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. 2. Department of Obstetrics, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany. 3. Department of Gynecology, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Abstract
BACKGROUND: Alloimmunization to red blood cells (RBCs) may result in fetal anemia prior to 20 weeks gestation. The question as to whether early commencement of antenatal treatment with high-dose intravenous immunoglobulins (IVIG) may prevent or at least delay the development of fetal anemia in the presence of alloantibodies to RBCs is highly relevant. PATIENTS AND RESULTS: Here we describe a patient with high-titer anti-K and two other severely affected pregnant women with a history of recurrent pregnancy loss due to high-titer anti-D or anti-D plus anti-C. Early commencement of treatment with IVIG (1 g/kg/week) resulted in prevention of intrauterine transfusion (IUT) in the former two cases, and in a significant delay of development of fetal anemia in the remaining case (26 weeks gestation). CONCLUSION: Based on our findings and of previously published cases, early initiation of treatment of severely alloimmunized women with IVIG (1 g/kg/week) could potentially improve the outcome of fetuses at risk.
BACKGROUND: Alloimmunization to red blood cells (RBCs) may result in fetal anemia prior to 20 weeks gestation. The question as to whether early commencement of antenatal treatment with high-dose intravenous immunoglobulins (IVIG) may prevent or at least delay the development of fetal anemia in the presence of alloantibodies to RBCs is highly relevant. PATIENTS AND RESULTS: Here we describe a patient with high-titer anti-K and two other severely affected pregnant women with a history of recurrent pregnancy loss due to high-titer anti-D or anti-D plus anti-C. Early commencement of treatment with IVIG (1 g/kg/week) resulted in prevention of intrauterine transfusion (IUT) in the former two cases, and in a significant delay of development of fetal anemia in the remaining case (26 weeks gestation). CONCLUSION: Based on our findings and of previously published cases, early initiation of treatment of severely alloimmunized women with IVIG (1 g/kg/week) could potentially improve the outcome of fetuses at risk.
Authors: G Mari; R L Deter; R L Carpenter; F Rahman; R Zimmerman; K J Moise; K F Dorman; A Ludomirsky; R Gonzalez; R Gomez; U Oz; L Detti; J A Copel; R Bahado-Singh; S Berry; J Martinez-Poyer; S C Blackwell Journal: N Engl J Med Date: 2000-01-06 Impact factor: 91.245
Authors: M C Fernández-Jiménez; M T Jiménez-Marco; D Hernández; A González; F Omeñaca; C de la Cámara Journal: Vox Sang Date: 2001-02 Impact factor: 2.144