Abstract

Reduction of Rh antibody titers in sensitized pregnant females has been carried out with intense plasmapheresis in 8 patients with bad Rh obstetric histories with prior fetal loss. As low titers are generally associated with less severely affected infants, this was studied as a means of lowering the titer to alleviate fetal effects of the isoimmunization process. Detailed studies of hematologic, nutritional, and biochemical changes as well as changes in the amniotic fluid have been done. Adjunctive measures of mercaptan administration, intrauterine transfusion, and plasma replacement were selectively used. Drops in Rh antibody titer have been achieved but not sustained, and cost factors limit clinical application. Depleted serum proteins rebound quickly. The safety of massive plasma removal in pregnancy has been shown and should help to stimulate its use in production of Rh-immune globulin.

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