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Maisonneuve E, Dugas A, Friszer S, et al. Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study. J Gynecol Obstet Hum Reprod. 2021;50(7):102119doi: 10.1016/j.jogoh.2021.102119.
Maisonneuve, E., Dugas, A., Friszer, S., Toly-Ndour, C., Cariot, L., Dhombres, F., Cortey, A., Mailloux, A., Carbonne, B., & Jouannic, J. M. (2021). Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study. Journal of gynecology obstetrics and human reproduction, 50(7), 102119. https://doi.org/10.1016/j.jogoh.2021.102119
Maisonneuve, Emeline, et al. "Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study." Journal of gynecology obstetrics and human reproduction vol. 50,7 (2021): 102119. doi: https://doi.org/10.1016/j.jogoh.2021.102119
Maisonneuve E, Dugas A, Friszer S, Toly-Ndour C, Cariot L, Dhombres F, Cortey A, Mailloux A, Carbonne B, Jouannic JM. Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study. J Gynecol Obstet Hum Reprod. 2021 Sep;50(7):102119. doi: 10.1016/j.jogoh.2021.102119. Epub 2021 Mar 16. PMID: 33741541.
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J Gynecol Obstet Hum Reprod. 2021 Sep;50(7):102119. doi: 10.1016/j.jogoh.2021.102119. Epub 2021 Mar 16.

Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study.

Journal of gynecology obstetrics and human reproduction

Emeline Maisonneuve, Anaïs Dugas, Stéphanie Friszer, Cécile Toly-Ndour, Laura Cariot, Ferdinand Dhombres, Anne Cortey, Agnès Mailloux, Bruno Carbonne, Jean-Marie Jouannic

Affiliations

  1. Fetal Medicine Department, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France; Clinical Unit of CNRHP: Centre National de Référence en Hémobiologie Périnatale, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France. Electronic address: [email protected].
  2. Fetal Medicine Department, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France.
  3. Fetal Medicine Department, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France; Clinical Unit of CNRHP: Centre National de Référence en Hémobiologie Périnatale, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France.
  4. Biological Unit of CNRHP: Centre National de Référence en Hémobiologie Périnatale, Saint-Antoine Hospital, 184 rue du Faubourg Saint-Antoine, Paris, France.
  5. Fetal Medicine Department, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France; Sorbonne Université, Paris, France.
  6. Obstetrics and Gynecology Department, Princesse Grace Hospital, 1, Avenue Pasteur, 98000, Monaco.
  7. Fetal Medicine Department, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France; Clinical Unit of CNRHP: Centre National de Référence en Hémobiologie Périnatale, Armand-Trousseau Hospital, 26, Avenue du Dr Arnold Netter, 75012, Paris, France; Sorbonne Université, Paris, France.

PMID: 33741541 DOI: 10.1016/j.jogoh.2021.102119

Abstract

BACKGROUND: Early intrauterine transfusion (IUT) is associated with a higher risk of fetal loss. Our objective was to evaluate the efficiciency of intravenous immunoglobulins (IVIG) to postpone the gestational age at first IUT beyond 20 weeks of gestation (WG) compared to the previous pregnancy in case of very severe red blood cell (RBC) alloimmunization.

STUDY DESIGN AND METHODS: Very severe RBC alloimmunization was defined by a high titer of antibodies and a previous pregnancy complicated by a first IUT before 24 WG and/or perinatal death directly related to alloimmunization. We performed a single-center case-control study. Cases and controls were patients respectively treated with weekly IVIG infusions started before 13 WG, and without.

RESULTS: Twenty cases and 21 controls were included. Gestational age (GA) at first IUT was postponed after 20 WG in 18/20 (90 %) of patients treated with IVIG and in 15/21 (71 %) in the control group (p = 0.24). Compared to the previous pregnancy, the GA at first IUT was postponed by a median of 22 [+11; +49] days in the IVIG group and occurred in average 2 days earlier [-17 ; +12] in the non-treated group (p = 0.02). There was no difference between number of IUT and need for exchange-transfusion. IVIG treatment was associated with a significant decrease of antibodies' quantitation.

CONCLUSION: In our series, IVIG tends to differ first IUT beyond 20 WG and have a significant effect in postponing the gestational age of the first IUT in patients with very severe RBC alloimmunization.

Copyright © 2021 Elsevier Masson SAS. All rights reserved.

Keywords: Fetal anemia; Hemolytic disease of the fetus and newborn; Intrauterine transfusion; Intravenous immunoglobulins; Very severe RBC alloimmunization

Conflict of interest statement

Declaration of Competing Interest The authors report no declarations of interest.

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