A new method for the treatment of blood group-incompatible pregnancy.
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概要
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Using an immunoadsorbent column (IM-P), we have found an effective treatment of blood group incompatible pregnancy (anti Diego b) with minimum side effects. The patient had a history of blood transfusion given at 12 years of age, and her first child had required exchange transfusion. She had a high titer of IgG anti-Dib before this pregnancy. Because the ΔOD 450 values of the amniotic fluid were elevated to zone 2 A of Liley's graph at 32 weeks of gestation, we performed plasma cleaning with IM-P. After the first treatment, the ΔOD 450 value fell to zone 3 of Liley's graph, and the anti-Dib titer in the maternal blood was kept at low levels by three more plasma cleanings until delivery. A viable mature but anemic newborn was delivered at 38 weeks of gestation and required exchange transfusion.<BR>The immunoadsorbent column (IM-P) is a muliporous polyvinyl alcohol gel, on which surface phenylalanine is immobilized as a ligand. This column has been used for systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients. As plasma protein did not decrease after plasma cleaning with this column, neither fresh frozen plasma nor plasma protein fraction was required for this procedure. They are required for plasmapheresis and sometimes cause hepatitis. Plasma IgG and IgA values fell sligtly with this treatment, but no other abnormal values were noted.This immunoadsorbent column may be applicable for the management of other blood type incompatible pregnancies.
- 近畿産科婦人科学会の論文
近畿産科婦人科学会 | 論文
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