Intensive antenatal plasmapheresis in severe rhesus isoimmunisation

Area of Science:

• Obstetrics and Gynecology
• Immunology
• Neonatology

Background:

• Rhesus haemolytic disease poses a severe risk to fetuses.
• High maternal Rh-antibody titers indicate significant fetal risk.

Purpose of the Study:

• To evaluate the efficacy of antenatal plasmapheresis in managing rhesus haemolytic disease.
• To assess the impact of plasmapheresis on Rh-antibody levels and fetal outcomes.

Main Methods:

• Plasmapheresis was performed intensively on pregnant mothers with Rh-sensitized pregnancies.
• Some mothers also received intrauterine transfusions.
• Outcomes were analyzed based on disease severity and timing of onset.

Main Results:

• Twenty-seven of forty-four mothers (61%) successfully delivered surviving infants when treated with plasmapheresis and intrauterine transfusions.
• Fifty-two mothers treated with plasmapheresis alone also showed positive outcomes.
• Treatment was less effective for early-onset severe disease but highly successful for late-onset severe disease.
• No significant maternal or fetal complications were reported.

Conclusions:

• Intensive antenatal plasmapheresis is a viable strategy for lowering Rh-antibody levels.
• The combination of plasmapheresis and intrauterine transfusions improves fetal survival in severe rhesus haemolytic disease.
• Timely intervention based on disease onset is crucial for optimal treatment success.