IMMUNOGLOBULIN THERAPY FOR HLA-RELATED RECURRENT FETAL LOSS

The efficacy of intravenous immunoglobulin (IgG) treatment was tested in 13 women presenting with recurrent, spontaneous fetal loss thought to be caused by immune rejection related to HLA-sharing between the sp ouses. IgG therapy (0.5 g/kg body wt, by slow intravenous infusion) wa s started at week 5 to 6 each new pregnancy, and the dose was repeated every 4 weeks up to a total of 6 doses or when the patient had achiev ed 24 weeks of successful gestation. Ten patients had a pregnancy cont inuing beyond 24 weeks, of whom 7 had spontaneous vaginal deliveries a t term, 3 are currently pregnant beyond the 30th week, and 2 patients became pregnant for the second time while on the same treatment. Three patients aborted in early pregnancy. The overall success rate was 80% . The side effects noted included headache, fever and skin rash; only one patient developed meningism. These results lend support to the use of intravenous immunoglobulin in the management of HLA-related recurr ent fetal loss.