ANTI-D-PROPHYLAXIS AFTER MASSIVE FETOMATE RNAL HEMORRHAGE

In the 36th week of gestation intrauterine death of both twins occurre d in a 31-year old primigravida. The examination of the C- and the D-a ntigen of the mother's blood (result of previous testing: AB Rhesus ne gative) immediately before delivery showed a mixed field agglutination which pointed to a fetomaternal macrotransfusion. Fetal haemoglobin i n the mother's circulation was 7.8% of her total haemoglobin, so that a fetomaternal haemorrhage of about 440 mi whole blood had to be suspe cted. For Rhesus-prophylaxis 17 standard doses of anti-D-immunoglobuli n were administered intramuscularly distributed over 4 days. No advers e effects were seen; fetal haemoglobin dropped to 2.0% 5 days and to 0 .1% 15 days after the beginning of the treatment. A control examinatio n after 9 months showed no signs of a Rhesus-(D)-sensitisation of the patient.