A successful delivery of an extremely immature infant in Rh incompatibility after plasma exchange

When Rh incompatible pregnancies occur, intrauterine fetal transfusion (IUT) and plasma exchange (PE) have made it possible to prolong the prenatal duration and to dramatically decrease the neonatal mortality. We administered a total of 10 PEs (from 20 weeks to 27 weeks of gestation) and one IUT (at 27 weeks and 1 day) for an Rh-isoimmunized gravida who already had a high maternal serum Rh antibody titer at the 14th gestational week, and delivered by Caesarian section (CS) an extremely immature infant of only 873 grams at 27 weeks and 4 days of gestation. The infant was hydropic with hyperbilirubinemia, therefore exchange transfusions were administered immediately after birth. The infant's weight reached the lowest point of 669 grams on the 13th day after birth, but began to increase thereafter. The baby weighted 3,052 grams on the 144th day and left the hospital without any complications.