A management programme for Rh alloimmunization during pregnancy.

A management programme for the control and treatment of Rh0 (D) immunized during pregnancy is presented. A total of 34,650 births were registered during a 4.5 year period and included 63 D positive newborns to D-immunized mothers. The outcome of all infants has been evaluated according to the severity of the haemolytic disease. Exchange transfusion was unnecessary in 43 mild cases (68.3%). Fourteen infants (22.2%) required exchange transfusion, and in 6 severe cases (9.5%) maternal plasma exchange and exchange transfusion was performed. No detrimental effects or deaths occurred among the infants suffering from Rh haemolytic disease. We recommend that the frequency and volume of plasma exchange therapy should be individually adjusted to suit each patient and the effect monitored regularly through maternal anti-D levels using a sensitive quantitative technique.