Planned conception in a hyper immunized rhesus-d negative mother by elective plasmapheresis.

ABSTRACT

Here we report a case of planned pregnancy in a Hyper immunized Rh D negative Banker lady who was interested to have a healthy baby in her fourth Gestation as previous conceptions were ended by intra uterine death (IUDs) due to Rhesus Hemolytic diseases of new born (HDN) which is a condition where the lifespan of the infant's red cells is shortened by the action of specific antibodies derived from the mother by placental transfer. The disease begins in intrauterine life and is therefore correctly described as hemolytic disease of the fetus (HDF) and new born, but the simple term HDN has been used for a long time and can be taken to include hemolytic disease of the fetus (HDF). This hemolytic process takes place in utero and results in marked compensatory overproduction of young nucleated red cells in fetal erythropoietic sites. For this reason the disease also called erythroblastosis foetalis. Elective plasmapheresis done at the Transfusion Medicine Department of BSMMU, Dhaka on her, 800 ml. plasma were extracted in 4 different sessions during her antenatal period. One healthy male baby was delivered by LUCS at 32 weeks of pregnancy; the Baby has to receive 170 ml. O negative fresh Whole Blood as Exchange Transfusion to correct mild hyper bilirubinimia and anemia. Manual plasmapheresis may thus be practiced to all Hyper-immunized carrying mothers to prevent intra uterine death (IUD) in Rhesus D negative carrying mothers.