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Case Reports in Obstetrics and Gynecology
Volume 2011 (2011), Article ID 157510, 4 pages
http://dx.doi.org/10.1155/2011/157510
Case Report

Successful Treatment of Fetal Intraperitoneal Administration of Immunoglobulin in a Case of Fetal Hemolytic Anemia with 131,072-Fold Anti-E Alloimmunization

1Department of Obstetrics and Gynecology, National Defense Medical College, 3-2 Namiki Tokorozawa, Saitama 3598513, Japan
2Division of Obstetrics and Gynecology, Matsuda Perinatal Clinic, 1080-5 Hongo, Tokorozawa, Saitama 3590022, Japan

Received 17 August 2011; Accepted 5 October 2011

Academic Editors: M. H. Eichbaum and Y. Ezra

Copyright © 2011 Masashi Yoshida et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Object. We present here the case of severe fetal anemia caused by anti-E antibody positive, which showed a favorable course only with fetal intraperitoneal administration of immunoglobulin. Case. The mother was 31 years old, blood type B Rh : CCDee, gravida 1, with no history of transfusion. Anti-E antibody was detected in the maternal cross-match test at the 18th gestational week. In percutaneous umbilical blood sampling, the umbilical blood hemoglobin level was 9.1 g/dL and the result of the direct Coombs' test was positive at the 26th gestational week. Immunoglobulin injection into fetal abdominal cavity (IFAC) was administered a total 7 times. During the pregnancy, the indirect Coombs' test showed a 131,072-fold increase. Conclusion. In this case, IFAC to block the reticuloendothelial system Fc receptor was successful. This procedure is promising as one of the treatment options for blood group incompatible pregnancy.