Open AccessAlloimmunization during pregnancy treated with high dose intravenous immunoglobulin
Author(s) -
Gottvall Tomas,
Selbing Anders
Publication year - 1995
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.3109/00016349509021196
Subject(s) - medicine , pregnancy , antibody , intravenous immunoglobulins , obstetrics , immunoglobulin g , intravenous use , immunology , anesthesia , genetics , biology
Background . High dose intravenous immunoglobulin has been reported to be advantageous in the treatment of alloimmunization during pregnancy. The mode of action is unknown. Method . High dose intravenous immunoglobulin was used as the sole prenatal treatment in six severely rhesus(D) sensitized pregnant women. Maternal and fetal anti‐D concentrations as well as fetal hemoglobin concentrations were studied. Seven pregnancies in rhesus(D) sensitized women served as controls. They received no treatment because they had milder forms of erythroblastosis fetalis or, in one case, a rhesus(D) negative fetus. Result . No obvious inhibitory effect of the treatment on maternal anti‐D production and transplacental anti‐D passage to the fetus was found. The fetal hemoglobin concentrations remained stable at about 80 g/L (hematocrit 27%) in five of six treated patients while there was a significant decrease in the control group. Conclusion . High dose intravenous immunoglobulin treatment seems to act mainly on fetal red cell destruction rate, possibly by blocking Fc receptor mediated macrophage phagocytosis. We claim that the treatment can successfully be used to prevent further deterioration of fetal anemia in rhesus(D) immunizations if started before severe fetal anemia (hemoglobin concentration < 70 g/L. hematocrit < 23%) and imminent hydrops fetalis arises.