Successful treatment of extremely severe fetal anemia due to Kell alloimmunization.
BACKGROUND
Repeated plasmapheresis was used to prevent fetal death from severe anti-Kell alloimmunization until intrauterine transfusions were feasible.


METHODS
Repeated maternal plasma exchanges (N = 40) beginning at 7 weeks' gestation were used to treat severe anti-Kell alloimmunization. Ultrasound examination at 19 weeks' gestation revealed diffuse hydrops in this fetus (umbilical venous hemoglobin, 1.2 g/dL), which then required nine intrauterine transfusions through 34 weeks. A healthy 3840-g girl was delivered by cesarean delivery at 36 weeks. Despite aplastic anemia during the first 3 months of life, she is healthy and has no observable abnormalities at age 8.


CONCLUSIONS
A highly aggressive course of plasmapheresis and intrauterine transfusions can successfully treat fetal anemia caused by anti-Kell alloimmunization even when fetal hemoglobin is extremely low.
Collinet
P
P
Clinique de Gynécologie, Obstétrique et Néonatalogie, Hôpital Jeanne de Flandre, Centre Hospitalier Régional Universitaire de Lille, Lille, France.
Subtil
D
D
Puech
F
F
Vaast
P
P
D000328:Adult; D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007626:Kell Blood-Group System; D010956:Plasmapheresis; D011247:Pregnancy
D007626:Kell Blood-Group System