[Management of severe neonatal Rh disease following in utero exchange transfusion: towards a new strategy].
Important changes in the prevention, diagnosis, and in utero treatment, of Rhesus allo-immunization in the past 30 years, have led to new neonatal clinical presentations. Based upon the analysis of 14 successive pregnancies with severe hemolytic disease, requiring in utero exchange-transfusion, it appears that the current management is no longer adapted to the new resulting clinical postnatal presentations. In the acute phase, intensive phototherapy associated with regular blood cell transfusion as required, appears to be a better policy than traditional postnatal systematic exchange transfusions. In addition endogenous erythropoiesis stimulation should be included in order to avoid any unnecessary transfusion.
Kneib
M T
MT
Service de médecine et réanimation néonatales, maternité régionale universitaire, 10, rue Dr-Heydenreich, BP 4213, 54042 Nancy, France.
Hamon
I
I
Miton
A
A
Hascoët
J M
JM
D000328:Adult; D001803:Blood Transfusion; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008431:Maternal-Fetal Exchange; D010789:Phototherapy; D011247:Pregnancy; D012189:Retrospective Studies; D012204:Rh-Hr Blood-Group System; D012720:Severity of Illness Index
D012204:Rh-Hr Blood-Group System