title: Rh isoimmunized pregnancy managed noninvasively: A report of two cases.
abstract: Pregnancy with Rh isoimmunization is a grave situation. Two women with indirect Coombs test (ICT) positive were managed conservatively with a favorable outcome. Peak systolic velocity (PSV) of middle cerebral artery (MCA) was measured every 2 weeks, and pregnancy continued till the value remained <1.5 mean of median. In one woman, the pregnancy could be prolonged to 37 weeks when delivery was induced and the neonate did not develop hyperbilirubinemia. In the second woman with bad obstetric history, when a highly positive ICT was reported, intravenous immunoglobulin (IVIG) was given in a single dose of 5 g every 2 weeks starting at 27 weeks, for a total of three doses, along with measurement of PSV of MCA. Labor could be prolonged to 34 weeks when preterm spontaneous delivery occurred. The neonate could be salvaged with exchange transfusion and IVIG. The neonate is healthy with normal tone and no evidence of kernicterus.
authors.affiliation: Department of Obstetrics and Gynecology, Chhotu Ram Hospital, Rohtak, Haryana, India.
authors.forename: Deepti
authors.initials: D
authors.lastname: Jain
keywords: Indirect Coombs test; Rh isoimmunization; intravenous immunoglobulin; mean of median; peak systolic velocity of middle cerebral artery