High-Dose Intravenous Immunoglobulin as the Sole Prenatal Treatment for Severe Rh Immunization

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Abstract
To the Editor: High-dose intravenous immunoglobulin has been shown to be effective in the treatment of several immune diseases, with no adverse effects.1 2 3 We have used this agent to improve the outcome of pregnancy in two women with severe Rh immunization.In Case 1, a 27-year-old woman in her third pregnancy presented with severe Rh immunization (anti-D titer, 1:1024 by indirect antiglobulin testing; anti-D concentration, 6.6 IU per milliliter by enzyme-linked antiglobulin testing; and a previous history of stillbirth). At 24 weeks' gestation, she began to receive high-dose intravenous immunoglobulin (Endobulin; 0.4 g per kilogram of body weight; Fig. 1). At . . .