Premium
Successful treatment of severe rhesus D‐incompatible pregnancy with repeated double‐filtration plasmapheresis
Author(s) -
Kamei Koichi,
Yamaguchi Koushi,
Sato Mai,
Ogura Masao,
Ito Shuichi,
Okada Tomomi,
Wada Seiji,
Sago Haruhiko
Publication year - 2015
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.21372
Subject(s) - medicine , plasmapheresis , pregnancy , hydrops fetalis , fetus , anemia , obstetrics , antibody , immunology , genetics , biology
Fetal anemia is caused by Rhesus (RhD) sensitization as a result of RhD incompatibility during pregnancy. The severe form of this disease can cause hydrops fetalis leading to intrauterine death. We experienced a highly sensitized 39‐year‐old woman with B Rh‐negative blood. She had a history of three induced abortions and experienced perinatal death associated with hydrops fetalis. During the pregnancy prior to her most recent one, she was treated with double‐filtration plasmapheresis (DFPP), high dose γ‐globulin and intrauterine fetal blood transfusion (IUT). For her most recent pregnancy, we performed only weekly or fortnightly DFPP from 13 weeks until delivery. Anti‐D antibody titer was maintained between 32 and 256 without any signs of fetal anemia. IUT was not required at any stage of the pregnancy. No adverse events were observed. She successfully delivered a healthy male infant weighing 2,289 g by Cesarean section at 35 weeks. Repeated DFPP may be an effective and safe strategy to reduce antibody titers in highly sensitized women with RhD‐incompatible pregnancy, avoiding the need for IUT. J. Clin. Apheresis 30:305–307, 2015. © 2014 Wiley Periodicals, Inc.