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Plasmapheresis and intravenous immune globulin for the treatment of D alloimmunization in pregnancy.
J Clin Apher. 2008 Nov 10
Novak DJ, Tyler LN, Reddy RL, Barsoom MJ.
Department of Pathology, Creighton University Medical Center, Omaha, Nebraska.
The
alloimmunized pregnancy can result in fetal and newborn mortality due
to fetal anemia. Control of fetal anemia has not been possible until
recently, and management consists of following the degree of fetal
anemia during gestation until intrauterine transfusion is feasible to
support the fetus until delivery. Cordocentesis and intrauterine
transfusion have potential complications that have been well
documented.
Control of fetal anemia via immune modulation utilizing
plasmapheresis and intravenous immune globulin administration has been
attempted alone and in combination with varying results. We present a
case report of an Rh(D) alloimmunized pregnancy, in which successful
management consisted of initial therapeutic plasmapheresis (TPE)
followed by intravenous immunoglobulin (IVIG) administration until
delivery at 37 weeks gestation without the need for intrauterine
transfusion. J. Clin. Apheresis, 2008. (c) 2008 Wiley-Liss, Inc.
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