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Background: The
prevalence of Rh alloimmunization has decreased following the use of anti-D
immunoglobulin. With serial amniocentesis, Doppler sonography of the middle
cerebral artery and treatment of anemia with intrauterine blood transfusion, perinatal
mortality has declined. However, Rh alloimmunization in twin pregnancies poses
a diagnostic and therapeutic challenge.
Case report: We are reporting,
for the first time in Iran, the successful treatment of severe Rh
alloimmunization in a dichorionic- diamnionic twin pregnancy leading to the
live births of both neonates. Before treatment, the fetal hemoglobin levels
were 3.1g/dL and 3.9g/dL, with ascites in both fetuses. The fetuses were
treated with several IUTs.
Results: After treatment, the neonates were
delivered, weighing 2200 and 2300g, with good Apgar scores, at a gestational
age of 34 weeks.
Conclusion: 10%
of population in Iran is Rh-negative, although Prophylaxis for Rh
alloimmunization is universal, as other part of the world it cannot irrigated.
For the best management of these cases, we need a well-equipped referral
center.
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