Document Detail


Intensive plasma exchange as an adjunct to management of severe rhesus disease.
MedLine Citation:
PMID:  3919526     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Large-volume plasma exchange was used to reduce the maternal anti-D concentration in a case of severe rhesus disease. The treatment commenced at 19 weeks' gestation and continued until the infant was successfully delivered at 35.2 weeks' gestation. The initial anti-D level of 30 IU/ml was lowered to 10 and was maintained below that level, with few exceptions throughout the program. The volume of plasma exchanged each week varied between 6.8 and 13.4 liters, a total of 154 l. Three IUTs were accomplished, starting from 31 weeks' gestation. The patient's OD values remained far below those recorded in her previous pregnancy which terminated in neonatal death. The replacement fluids consisted of 98 l PPS with FFP added to equilibrate the patient at the end of each procedure, altogether 33 l. At 33 weeks' gestation she developed a transient non-A, non-B hepatitis probably caused by the use of FFP. However, she later made a complete recovery. Large-volume plasma exchanges commenced early in high-risk pregnancy must be individually designed and based on the kinetics of anti-D production. The replacement fluids should preferably consist of pasteurized albumin solutions and intravenous immune globulin.
Authors:
J Eklund
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  64     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  1985  
Date Detail:
Created Date:  1985-04-08     Completed Date:  1985-04-08     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  SWEDEN    
Other Details:
Languages:  eng     Pagination:  7-10     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Antibodies / analysis
Antigens / analysis
Erythrocytes / immunology
Female
Humans
Infant, Newborn
Plasma Exchange* / methods
Plasmapheresis
Pregnancy
Rh Isoimmunization / therapy*
Rh-Hr Blood-Group System / immunology
Chemical
Reg. No./Substance:
0/Antibodies; 0/Antigens; 0/Rh-Hr Blood-Group System

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


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