REPEATED DIRECT FETAL INTRAVASCULAR HIGH-DOSE IMMUNOGLOBULIN THERAPY FOR THE TREATMENT OF RH HEMOLYTIC-DISEASE

Recently, administration of high-dose intravenous immunoglobulin (HDiv IG) either to the mother or the neonate has been proposed in an effort to prevent progressive hemolysis in Rh(D) perinatal disease, but no c ases have been published with direct fetal HDivIG administration. We r eport a case in which HDivIG was repeatedly administered by cordocente sis to a fetus affected by Rh(D) disease from 28 to 36 weeks gestation , at doses of approximately 450 mg/kg. The fetus required no transfusi ons, and the neonatal evolution was satisfactory. The treatment, perfo rmed at three weeks intervals, seemed to be useful in preventing fetal hemolysis. No fetal complications were present. Recurrent administrat ion of HDiVIG therapy to the fetus in cases of severe Rh(D) disease, a ppears to be feasible and free of serious complications to the fetus o r the mother.