Document Detail


Alloimmunization during pregnancy treated with high dose intravenous immunoglobulin. Effects on fetal hemoglobin concentration and anti-D concentrations in the mother and fetus.
MedLine Citation:
PMID:  8533559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
T Gottvall; A Selbing
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Publication Detail:
Type:  Clinical Trial; Journal Article; Review    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  74     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  1995 Nov 
Date Detail:
Created Date:  1996-01-31     Completed Date:  1996-01-31     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  DENMARK    
Other Details:
Languages:  eng     Pagination:  777-83     Citation Subset:  IM    
Affiliation:
Department of Obstetrics and Gynecology, Faculty of Health Sciences, Link?ping University, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Dose-Response Relationship, Drug
Erythroblastosis, Fetal / immunology,  prevention & control
Female
Fetal Hemoglobin / analysis*
Humans
Immunoglobulins / administration & dosage*
Infant, Newborn
Injections, Intravenous
Maternal-Fetal Exchange
Pregnancy
Pregnancy Complications, Hematologic / immunology*
Rh Isoimmunization / immunology*
Rho(D) Immune Globulin / immunology*
Chemical
Reg. No./Substance:
0/Immunoglobulins; 0/Rho(D) Immune Globulin; 9034-63-3/Fetal Hemoglobin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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