Mayer Beate, Hinkson Larry, Hillebrand Wiebke, Henrich Wolfgang, Salama Abdulgabar
Institute of Transfusion Medicine, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Department of Obstetrics, Charité - Universitätsmedizin Berlin, Campus Virchow-Klinikum, Berlin, Germany.
Transfus Med Hemother. 2018 Nov;45(6):429-436. doi: 10.1159/000490154. Epub 2018 Oct 31.
Alloimmunization to red blood cells (RBCs) may result in fetal anemia prior to 20 weeks gestation. The question as to whether early commencement of antenatal treatment with high-dose intravenous immunoglobulins (IVIG) may prevent or at least delay the development of fetal anemia in the presence of alloantibodies to RBCs is highly relevant.
Here we describe a patient with high-titer anti-K and two other severely affected pregnant women with a history of recurrent pregnancy loss due to high-titer anti-D or anti-D plus anti-C. Early commencement of treatment with IVIG (1 g/kg/week) resulted in prevention of intrauterine transfusion (IUT) in the former two cases, and in a significant delay of development of fetal anemia in the remaining case (26 weeks gestation).
Based on our findings and of previously published cases, early initiation of treatment of severely alloimmunized women with IVIG (1 g/kg/week) could potentially improve the outcome of fetuses at risk.
对红细胞（RBC）的同种免疫可能在妊娠20周前导致胎儿贫血。在存在针对RBC的同种抗体的情况下，早期开始使用高剂量静脉注射免疫球蛋白（IVIG）进行产前治疗是否可以预防或至少延迟胎儿贫血的发生这一问题具有高度相关性。
在此，我们描述了一名具有高滴度抗-K的患者以及另外两名严重受影响的孕妇，她们有因高滴度抗-D或抗-D加抗-C导致反复流产的病史。早期开始使用IVIG（1 g/kg/周）治疗在前两例中预防了宫内输血（IUT），在其余病例（妊娠26周）中显著延迟了胎儿贫血的发展。
基于我们的研究结果以及先前发表的病例，早期开始对严重同种免疫的女性使用IVIG（1 g/kg/周）治疗可能会改善有风险胎儿的结局。
