We have treated 25 women with poor obstetric histories and high levels of anti-Rh antibodies by plasmapheresis during pregnancy. One baby was Rs negative, but 13 of the remaining 24 babies survived. Most of the foetal deaths were associated with a rapid rise in antibody level uncontrollable by plasmapheresis and which followed either amniocentesis or intra-uterine transfusion. Plasmapheresis throughout pregnancy with early delivery and avoidance of amniocentesis is recommended.
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Veer-KorthofE.T., NitenenkJ.S.G., NieuwkoopJ.A., EernisseJ.G.: IgG subclasses in Rhesus-D immunisation. Effects of weekly small volume plasmapheresis.Vox. Sang.41: 207–211, 1981.
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BarclayG.R., GreissM.A., UrbaniakS.J.: Adverse effect of plasma exchange on anti-D production in rhesus immunisation owing to removal of inhibitory factors.Brit. Med. J.1: 1569–71, 1980.
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BystrynJ.C., GrafM.W., UhrJ.W.: Regulation of antibody formation by serum antibody.J. Exp. Med.132: 1279–1287, 1970.
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HamblinT.J.: Plasmapheresis and Plasma Exchange Volume 1.Annual Research Reviews Montreal:Eden Press p. 99, 1979.
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