Massive feto-maternal haemorrhage: effect of passively administered anti-D in the prevention of Rh sensitization and haemolytic disease of the newborn.
Fourteen mothers carrying ABO compatible but Rh D incompatible pregnancies experienced large feto-maternal haemorrhages (estimated 188 ml, range 50-400 ml red cells). These were all treated with infusions of fresh frozen plasma containing anti-D at a mean immunoglobulin to fetal cell ratio of 129 i.u. (25.8 micrograms)/ml of fetal cells. At 48 h after the infusion 95% of fetal cells had been removed but 3 to 4 days were required for complete removal. The passively administered anti-D was detectable for up to 6-9 months but not after that time. Four of the 14 women had successful pregnancies subsequently although in two of these anti-C + D was present. Of these, one resulted in a clinically affected baby who survived exchange transfusion.
Mills
L
L
Welsh Regional Transfusion Centre, Rhydlafar, Cardiff.
Napier
J A
JA
D004899:Erythroblastosis, Fetal / Q000517:prevention & control*; D005260:Female; D005313:Fetal Death; D005331:Fetomaternal Transfusion; D006801:Humans; D007116:Immunization, Passive; D007136:Immunoglobulins / Q000008:administration & dosage*; D007231:Infant, Newborn; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000517:prevention & control*; D018029:Rho(D) Immune Globulin; D013997:Time Factors
D007136:Immunoglobulins; D018029:Rho(D) Immune Globulin