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Immunoglobulin administration to fetuses with anemia due to alloimmunization to D
Author(s) -
Ulm B.,
Kirchner L.,
Svolba G.,
Jilma B.,
Deutinger J.,
Bernaschek G.,
Panzer S.
Publication year - 1999
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1046/j.1537-2995.1999.39111235.x
Subject(s) - fetus , medicine , anemia , antibody , pregnancy , immunology , obstetrics , biology , genetics
BACKGROUND: The purpose of this study was to examine fetal tolerance of high‐dose intravenous immunoglobulin (IVIG), given directly at the time of intravascular transfusion, and its effects on fetal hemolysis and pregnancy outcome in the setting of alloimmunization to D. STUDY DESIGN AND METHODS: Thirteen consecutive D+ fetuses requiring transfusion for maternal alloimmunization received high‐dose IVIG (1.0 g/kg) and red cell transfusions. Twenty‐four previous, consecutive fetuses with maternal anti‐D served as controls. The schedules for subsequent transfusions were the same in the two groups. RESULTS: High‐dose IVIG was well tolerated by all fetuses. In the IVIG group, daily decreases in hematocrit were smaller than those in controls after the second administration of IVIG (mean hematocrit decrease, 0.72 percent/day vs. 1.45 percent/day; p = 0.007). No significant difference was found in the total number of fetal transfusions, the gestational age at delivery, the duration of neonatal intensive care, the number of neonates requiring postnatal transfusion therapy, and perinatal mortality. CONCLUSION: In this small pilot study, direct administration to fetuses of IVIG with red cell transfusions was well tolerated and appeared to have a beneficial effect on fetal hemolysis.