NEONATAL ADMINISTRATION OF HIGH-DOSE INTRAVENOUS IMMUNOGLOBULIN IN RHESUS HEMOLYTIC-DISEASE

Our aim was to assess the effectiveness of neonatal treatment of Rh he molytic disease with high-dose intravenous immunoglobulin (HDIVIG), in reducing neonatal hemolysis. A total of 40 neonates born to isoimmuni zed Rh negative women were studied. The population was randomized into 2 groups: Group 1 received IVIG 800 mg/kg/day for 3 days, plus photot herapy; and Group 2 received only phototherapy. No significant differe nce was observed between the groups in the severity of either the ante natal and neonatal disease, mode of delivery, mean birthweight, gestat ional age at delivery, proportion of preterm deliveries, 1 minute Apga r Score, days of phototherapy, and presence of neonatal cholestasis. G roup 1 babies showed a significantly decreased duration of hospitaliza tion, less hemolysis, and a less marked increase in bilirubin levels o n the first day of life than Group 2 newborns. Therefore, Group 1 neon ates received less treatment with transfusions (exchange-transfusions and/or simple blood treatment with transfusions) than those in Group 2 . Our data suggest that the frequency of transfusional therapy can be reduced by combining conventional phototherapy with HDIVIG. Further st udies are needed to determine the optimum timing and dosages of neonat al HDIVIG treatment.