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KMID : 0387719940050010063
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Korean Journal of Blood Transfusion
1994 Volume.5 No. 1 p.63 ~ p.69
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A Case of a E-isolimmunized Woman by Previous transfusion who was Treated with Antenatal Plasma Exchanges, IVIG and intrauterine Transfusion
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이위교
최태윤/김원배/이동화/강득용/이권해
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Abstract
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Since the introduction of Rh-immune globulin in 1968, the incidence of Rh D hemolytic disease of the newhbcrn (HDN) had become markedly reduced but in the contrary the HDN by minor blood group antibodies has become increased relatively. As anti-E
is the
most common minor blood group antibody identified in antenatal serology and because of the frequency of E-negative people in korea is ranged from 38.8% to 50.3%, the probability of HDN caused by anti-E is expected relatively high.
We had experienced antenatal therapy for a E-isoimmunized pregnant woman, who has the history of one previous stillbirth and one neonatal death. In addition to above obstetric history, she had a history of blood transfusion, in which she was
given
7
units of whole blood during the operation of brain cyst 7 years ago, before her marriage. Therapeutic plasma exchanges were repeated from the 22nd to 25th weaks of gestation. During the period a mean volume of 350mL plasma volume was exchanged on
average twice a week. After the period, therapeutic plasma exchange procedure was failed becaused of unsuccessful vascular access. So that wee gave her intravenous immunoglobulin (IVIG), 0.4gm/kg for 5 days, and two intrauterine transfusion were
given
at 25th and 27th weeks of gestation HDN. The maximal antiglobulin titer of anti-E during the gestation period was 1:32. In spite of intensive therapy as above mentioned, she was delivered a severely hydropic fetus weighing 1,900g at 29th weeks of
gestation under Cesarean section. The neonate died 2 days after the birth with severe erythroblastosis fetalis and disseminated intravascular coagulation (DIC).
Even though we could not save the baby, we report this experience as a reviewable case of antenatal treatment modalities for Rh immunization and the serious consequence of blood transfusion before marriage.
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KEYWORD
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