Effect of intravenous immunoglobulins to postpone the gestational age of first intrauterine transfusion in very severe red blood cell alloimmunization: A case-control study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue Journal of Gynecology Obstetrics and Human Reproduction Année : 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

Emeline Maisonneuve
Anaïs Dugas
Stéphanie Friszer
  • Fonction : Auteur
Cécile Toly-Ndour
Laura Cariot
Anne Cortey
  • Fonction : Auteur
Agnès Mailloux
  • Fonction : Auteur
Bruno Carbonne
  • Fonction : Auteur

Résumé

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.
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hal-04008683 , version 1 (24-04-2023)

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Paternité - Pas d'utilisation commerciale

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Emeline Maisonneuve, Anaïs Dugas, Stéphanie Friszer, Cécile Toly-Ndour, Laura Cariot, 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, 2021, 50 (7), pp.102119. ⟨10.1016/j.jogoh.2021.102119⟩. ⟨hal-04008683⟩
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