Intravenous immunoglobulin as primary therapy or adjuvant therapy to intrauterine fetal blood transfusion: a new approach in the management of severe Rh-immunization.
Maternal high dose intravenous immunoglobulin (IVIG) has shown promise in the management of severe Rh-immunization. Intravenous immunoglobulin, blocks Fe mediated antibody transport across the placenta and blocks destruction of fetal red cells and reduces maternal antibody levels. We have tried this new therapy in 6 patients with severe Rh-immunization, with high maternal antibody titres and previous hydrops and intrauterine deaths. Intravenous immunoglobulin was given from 13-18 weeks of gestation 3-4 weekly, till intrauterine transfusion (IUT) or delivery. Intensive fetal monitoring was done. No fetal hydrops or deaths occurred in any of the 6 cases. Only 2 cases needed intrauterine transfusion. IVIG delayed the onset of fetal anemia by 8-17 weeks thus deferring the need for IUT. All pregnancies continued till 32-36 weeks and all 6 babies did well in the neonatal period.
Deka
D
D
Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India.
Buckshee
K
K
Kinra
G
G
D001805:Blood Transfusion, Intrauterine; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D005865:Gestational Age; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D010865:Pilot Projects; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000628:therapy*; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous