Perinatal management of fetal hemolytic disease due to Rh incompatibility combined with fetal alloimmune thrombocytopenia due to HPA-5b incompatibility

We report our experience in the perinatal management of a complex case of f etal hemolytic disease primarily due to Rhesus incompatibility combined wit h fetal alloimmune thrombocytopenia. The lowest fetal hemoglobin and platel et levels were 2.6 g/dl and 13000/mu l,respectively Intra-uterine treatment consisted of six transfusions of packed red cells into the umbilical vein and one transfusion of platelets. The neonate required Jolts transfusions o f packed red cells to correct her hyporegenerative erythropoiesis. Postnata l management also included one platelet transfusion, intravenous immunoglob ulins and erythropoietin. Although some degree of fetal thrombocytopenia ma y invariably De found ind in fetal red cell incompatibility, other rave cau ses need 50 be excluded.