| Popis: |
Between 1974 and 1985 16 pregnant women at high risk of foetal loss due to Rhesus isoimmunization received antenatal plasma exchange with 4.5% human albumin solution once or twice weekly throughout the second trimester until delivery, usually at 28–29 weeks. Overall foetal survival was 75% (92% since 1980). Of 11 children followed for up to 4 yr, development is entirely normal in 7. Two have had periods of dystonia, and two others have had delay in language development and motor skills respectively, but all four are improving. Immunoglobulins were replaced by human intramuscular immunoglobulin, thus avoiding the allergenic and viral hazards of fresh frozen plasma. Although direct intravascular transfusion may eventually supercede plasma exchange, the regime described here can produce good overall quality of long-term outcome for selected patients. |
