Successful double filtration plasmapheresis treatment in an Rh(E)-incompatible pregnancy

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  • Rh(E)血液型不適合妊娠にdouble filtration plasmapheresis(DFPP)を施行した1例
  • 症例報告 Rh(E)血液型不適合妊娠にdouble filtration plasmapheresis(DFPP)を施行した1例
  • ショウレイ ホウコク Rh(E)ケツエキガタ フテキゴウ ニンシン ニ double filtration plasmapheresis(DFPP)オ シコウ シタ 1レイ

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Abstract

A 33-year-old woman was referred to our hospital following 2 habitual abortions. Her blood type was ccDee, and her husband was CCdeE. At the third pregnancy, her serum anti-E antibody was 1:512 after 9 weeks of pregnancy, and its titer increased gradually. Therefore, we started double filtration plasmapheresis from 12 weeks of pregnancy, and it was performed a total of 34 times. Five-unit transfusion was performed via the funiculus umbllicalis, because severe anemia was recognized in the embryo. She gave birth to a girl by cesarean section in the 34th week. The newborn infant underwent exchange transfusion, and was treated by the administration of γ-globulin and actinotherapy in the NICA. The infant left the hospital showing a favorable course on the 62nd day. The spread of immune globulin therapy and progress of the iatrotechnique of intrauterine fetal transfusion have increased the role of plasma exchange for pregnant mothers with Rh(E)-incompatible pregnancy. However, PE is necessary for cases such as this with a high titer of antibody in Rh(E)-incompatible pregnancy. In addition, DFPP is a superior therapy, and there are few side effects.

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