Research Library

Premium No Beneficial Effect of Low‐Dose Fetal Intravenous Gammaglobulin Administration in Combination with Intravascular Transfusions in Severe Rh D Haemolytic Disease
Author(s)
Dooren Marion C.,
Kamp Inge L.,
Scherpenisse Jan W.,
Brand Ronald,
Ouwchand Willem H.,
Kanhai Humphrey H. H.,
Engelfriet C. Paul,
Gravenhorst Jack Bennebroek
Publication year1994
Publication title
vox sanguinis
Resource typeJournals
PublisherBlackwell Publishing Ltd
Abstract Recent observations have shown that treatment with high‐dose intravenous gammaglobulin (IVIgG) given to the mother may improve fetal outcome in cases of severe Rh D alloimmunization. Unfortunately, the costs of this new method of treatment are too high for routine use. Therefore, we decided to apply this treatment to the fetus and to investigate whether the effect of IVIgG might be attributable to blockade of the fetal mononuclear phagocyte system. We have performed a randomized study in which 20 fetuses with severe Rh D‐haemolytic disease (HDN) were treated with intrauterine intravascular red cell transfusions (IUT). In 10 of these 20 cases transfusions were followed by administration to the fetus of low‐dose IVIgG (85.7 ± 11.6 mg/kg by ultrasound‐estimated fetal weight because of fetal vascular volume considerations). We compared the number of IUTs, postnatal exchange transfusions, haematocrit (Ht) and haemoglobulin (Hb) values before and after transfusion (s) needed by the newborns of the two groups. No significant differences in the transfusion requirements of the fetuses and in the clinical outcome could be demonstrated. However, the 95% confidence interval for the difference in the improvement of cord blood Ht was too wide for any conclusions. The 95% confidence interval for the difference in the improvement of Hb levels suggests that any clinically relevant advantage of IVIgG on Hb is unlikely.
Subject(s)biology , fetus , genetics , medicine , pregnancy
Language(s)English
SCImago Journal Rank0.68
H-Index83
eISSN1423-0410
pISSN0042-9007
DOI10.1111/j.1423-0410.1994.tb00324.x

Seeing content that should not be on Zendy? Contact us.

This content is not available in your region!

Continue researching here.

Having issues? You can contact us here