Application of plasma exchange in patients with history of unexplained recurrent abortion: a case series

Immune-mediated recurrent pregnancy loss (RPL) has received more attention than any other single etiologic classification. Individuals with rare blood group P have an antipp1pk antibody in their serum, which causes recurrent abortion in the early stages.

In this case series study, 11 patients with unexplained RPL who had anti-P antibody in their serum were treated by plasma exchange during their next pregnancies. To evaluate the efficacy of the treatment, we monitored fetal development using ultrasonography and intensive prenatal care. All calculations were performed with the SPSS version 16.

All patients who were treated by plasma exchange progressed to live birth. The mean gestational age at the time of termination was 37.5 ± 0.69 weeks. The mean weight of the newborns was 2729.09 ± 389.88 g. None of the newborns required exchange transfusion.

P-incompatibility is one rare but important cause of unexplained RPL and also a basis for therapeutic intervention via early antibody removal by plasma exchange.