Antenatal immunoglobulin for fetal red blood cell alloimmunization.

BACKGROUND

Red blood cell alloimmunization in pregnancy can lead to fetal anaemia with potentially disastrous consequences. Traditional management involves the use of intrauterine transfusion, which is associated with significant procedure-related risks. An alternative treatment that has been trialled is the use of immunoglobulin administered intravenously to the mother.

OBJECTIVES

The objective of this review was to assess the efficacy and safety of the use of intravenous immunoglobulin antenatally to women with severe fetal red blood cell alloimmunization.

SEARCH METHODS

We searched the Cochrane Pregnancy and Childbirth Group trials register (19 December 2012), and reference lists of articles.

SELECTION CRITERIA

Randomized trials assessing the antenatal use of intravenous immunoglobulin administered at any dose, frequency or duration with a control group (using any other, or no treatment) in the management of fetal red blood cell alloimmunization.

DATA COLLECTION AND ANALYSIS

Two review authors independently assessed the available evidence.

MAIN RESULTS

There are no included studies.

AUTHORS' CONCLUSIONS: No information is available from randomized trials to indicate whether the antenatal use of intravenous immunoglobulin is effective in the management of fetal red blood cell alloimmunization. Several case series suggest a beneficial role in delaying the onset of fetal anaemia requiring invasive intrauterine transfusion.