Novak Deborah J, Tyler Lisa N, Reddy Ramakrishna L, Barsoom Michael J
Department of Pathology, Creighton University Medical Center, Omaha, Nebraska 68131, USA.
J Clin Apher. 2008;23(6):183-5. doi: 10.1002/jca.20180.
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.
同种免疫妊娠可因胎儿贫血导致胎儿和新生儿死亡。直到最近，控制胎儿贫血才成为可能，管理措施包括在妊娠期跟踪胎儿贫血程度，直至可行宫内输血以支持胎儿直至分娩。脐带穿刺术和宫内输血有已得到充分记录的潜在并发症。已尝试单独或联合使用血浆置换和静脉注射免疫球蛋白通过免疫调节来控制胎儿贫血，结果各异。我们报告一例Rh(D)同种免疫妊娠病例，成功的管理措施包括最初进行治疗性血浆置换（TPE），随后静脉注射免疫球蛋白（IVIG），直至妊娠37周分娩，无需进行宫内输血。
