Prevention of Fetal Anemia with Plasma Exchange and Intravenous Immunoglobulin in a Pregnancy with a Complex Anti-K and Anti-C Alloimmunization

Abstract Hemolytic disease of the fetus and newborn (HDFN) remains main cause fetal anemia primarily due to RH-D maternal incompatibility but also other rarer antigens. Anti-Kell mediated immunization is a rare involving about 0.1% pregnant women causing more severe HDFN compared both for its mechanism because lack preventive immunoglobulin therapy. Although standard treatment intrauterine transfusion (IUT), at early gestational age with high antibody titer absence ultrasound signs, noninvasive strategies can be offered. We present case anti-Kell anti-C Rh positive immunized pregnancy Kell 14 weeks gestation that successfully treated plasma exchange intravenous prevent onset avoid need IUT.