Antenatal immunoglobulin for fetal red blood cell alloimmunization

Cochrane Database Syst Rev. 2013 May 31:(5):CD008267. doi: 10.1002/14651858.CD008267.pub2.

Abstract

Background: Red blood cell alloimmunization in pregnancy can lead to fetal anaemia with potentially disastrous consequences. Traditional management involves the use of intrauterine transfusion, which is associated with significant procedure-related risks. An alternative treatment that has been trialled is the use of immunoglobulin administered intravenously to the mother.

Objectives: The objective of this review was to assess the efficacy and safety of the use of intravenous immunoglobulin antenatally to women with severe fetal red blood cell alloimmunization.

Search methods: We searched the Cochrane Pregnancy and Childbirth Group trials register (19 December 2012), and reference lists of articles.

Selection criteria: Randomized trials assessing the antenatal use of intravenous immunoglobulin administered at any dose, frequency or duration with a control group (using any other, or no treatment) in the management of fetal red blood cell alloimmunization.

Data collection and analysis: Two review authors independently assessed the available evidence.

Main results: There are no included studies.

Authors' conclusions: No information is available from randomized trials to indicate whether the antenatal use of intravenous immunoglobulin is effective in the management of fetal red blood cell alloimmunization. Several case series suggest a beneficial role in delaying the onset of fetal anaemia requiring invasive intrauterine transfusion.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anemia, Hemolytic / immunology
  • Anemia, Hemolytic / prevention & control*
  • Erythrocytes / immunology*
  • Female
  • Fetal Diseases / immunology
  • Fetal Diseases / prevention & control*
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunologic Factors / administration & dosage*
  • Pregnancy

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors