Intensive Antenatal Plasmapheresis in Severe Rhesus Isoimmunisation

Fraser, I.D.; Bennett, Marjorie; Bothamley, Joy; Airth, G. R.; Lehane, Daniel E.; McCarthy, Molly; Roberts, Fred

doi:10.1016/s0140-6736(76)92906-8

Cited by 101 publications

(24 citation statements)

References 11 publications

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“…The presence of anti-PPjPk is considered a potent cause of abortion, and the IgG anti-P and anti-Pk fractions seem to play a significant role [1][2][3][4][5]. The inci dence of spontaneous abortion in Pk females is unknown [6], but two cases of repeated fetal loss during the first trimester have been reported in the literature [6,7], and anti-P has been proposed as the cause.Plasma exchange is intended to lower the plasma anti body level in the management of women with blood group-incompatible pregnancies [8], and while much is known about this treatment in women who have had severely affected infants or fetal loss due to Rh and Kell incompatibility in late pregnancy [9], little is known of its success in women in whom the fetal loss has occurred in the first trimester. Two reports recently appeared in the literature in which women who were Pk and had had multiple abortions in the first trimester were successfully treated, either by plasmapheresis [6] or by plasmapheresis combined with antibody absorption [7], and both deliv ered a live child.…”

mentioning

confidence: 99%

Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p

Schechter¹,

Timor‐Tritsch²,

Lewitt³

et al. 1987

Vox Sanguinis

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Women with the rare blood group p are known to have an increased rate of abortions. The case of a 36-year-old woman is presented who had had 7 spontaneous abortions in the first trimester and no live child. When treated by plasma exchange begun early in pregnancy and continued until the 29th week, she delivered a normal child. Time to begin, amount and length of time necessary to continue plasma exchange in these patients are considered. In addition, the question of which fraction of the anti-PP(1)P^k could be responsible for abortion is discussed. To our knowledge, this is the first case of a woman of p phenotype with no live children but with multiple abortions treated by this method, which should be seriously considered in similar cases.

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mentioning

confidence: 99%

Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p

Schechter¹,

Timor‐Tritsch²,

Lewitt³

et al. 1987

Vox Sanguinis

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“…only 1 of these was diagnosed and treated from the 1st trimester (11 weeks) [61]. Among 68 pregnancies, during which plasma exchange was performed for Rh incompatibil ity [67,68], only 2 patients were treated from the 1st trimester (after 10 weeks). These pa tients received only one exchange per week.…”

Section: Treatmentmentioning

confidence: 99%

Thrombotic Thrombocytopenic Purpura in Pregnancy: Successful Treatment with Plasma Exchange

et al. 1995

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Thrombotic thrombocytopenic purpura (TTP) is a rare syndrome which presents typically with thrombocytopenia, microangiopathic hemolytic anemia, central nervous system symptoms, fever, and renal abnormalities. The diagnosis of TTP in pregnancy previously carried a poor prognosis and a high fetal mortality when presenting early in gestation. This case report describes the earliest presentation of TTP in pregnancy (6 weeks of gestation) we could identify in the literature treated successfully with a prolonged course of plasma exchange. The differential diagnosis and the pathogenesis of TTP in pregnancy are reviewed. Therapeutic options and data regarding the removal of pregnancy-related hormones by plasma exchange are presented.

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“…Plasmapheresis is often carried out in combination with intrauterine transfusions. Fraser et al [90] reported an overall success rate of 61.5% (59/96) with intensive antenatal plasmapheresis. Rubinstein [97], studying the mechanism of control of antibody levels using quantita tive hemagglutination in an autoanalyzer, found that about one half of the individuals sensitized to antigen exhibited clear-cut cycles with 7-day periods.…”

Section: Plasmapheresismentioning

confidence: 99%

“…Plasma exchange, during which large volumes of plas ma are often removed and replaced with donor plasma, is recommended by some authors as the most suitable meth od of management in hemolytic disease of the fetus [89][90][91][92][93][94][95][96]. Plasmapheresis is often carried out in combination with intrauterine transfusions.…”

Section: Plasmapheresismentioning

confidence: 99%

Management of Serious Alloimmunization in Pregnancy

Gravenhorst¹

1988

Vox Sanguinis

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In the past 40 years, tremendous advances in the treatment of hemolytic disease have been made. The perinatal mortality has been reduced considerably. Rh immunoprophylaxis has decreased the incidence of Rh immunization to around 6 per 100,000 live births. Nevertheless, treatment of severe hemolytic disease is still essential. Increased reliability of diagnostic procedures have made early detection and optimal treatment of hemolytic disease possible. Treatment by plasmapheresis is still controversial. Although believed to be beneficial by some authors, conclusive evidence of its efficacy has not been obtained. With preterm induction of birth at 32 weeks of gestation, the chances for survival are 95%. Improvement of techniques and the use of modern real-time ultrasound equipment have made intrauterine intraperitoneal transfusion, in experienced hands, a relatively safe and successful procedure. Intravascular transfusion appears beneficial in early pregnancy. Combination of both techniques will probably be the answer for the future. The development of neonatal intensive care facilities has made a major contribution to the survival of children with haemolytic disease. The relative low incidence of haemolytic disease has made it imperative that treatment should take place in centers where experience and special skill are available.

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Intensive Antenatal Plasmapheresis in Severe Rhesus Isoimmunisation

Cited by 101 publications

References 11 publications

Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p

Early Treatment by Plasmapheresis in a Woman with Multiple Abortions and the Rare Blood Group p

Thrombotic Thrombocytopenic Purpura in Pregnancy: Successful Treatment with Plasma Exchange

Management of Serious Alloimmunization in Pregnancy

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