Red cell exchange in the pregnancy complicated by a major hemoglobinopathy.

A new method of partial erythrocyte exchange for pregnancies complicated by a major hemoglobinopathy is described. The Haemonetics 30 Cell Separator allows efficient withdrawal and discard of the patient's erythrocytes. The patient's leukocytes, platelets, and plasma are conserved and returned with washed, compatible donor red cells which contain Hb AA. Three pregnant black women with significant hemoglobinopathies were treated by this modality during their pregnancies. Vaginal term deliveries were accomplished in each case. The method offers advantages in the efficiency of blood quantity displacement, patient comfort, adaptability to the patient with severe anemia, and the use of outpatient facilities. The method is suggested for use whenever a patient with an obstetrically significant hemoglobin variant needs transfusions of erythocytes.