FIELD: medicine.
SUBSTANCE: invention relates to medicine, namely to obstetrics and gynecology, and can be used in treatment of rhesus sensitisation and prevention of hemolytic disease of fetus. For this purpose titre of rhesus-antibodies is determined and if titre of rhesus-antibodies is higher than 1:32 and high titre of subclasses IgG1 and IgG3 carried out is course of therapeutic plasmapheresis, which includes from 3 to 5 sessions with removal of 10-30% of circulating plasma volume. Plasma compensation is performed with hydroxyethylated starch with ratio to removed plasma 1.2-1.5:1. Interval between sessions of therapeutic plasmapheresis constitutes 1-2 days. After finishing course of therapeutic plasmapheresis, intravenous immunoglobulin therapy is performed in dose 5.0 g with interval between immunoglobulin transfusions 1-2 days. If titre of rhesus-antibodies higher than 1:32 and high titre of subclasses IgG1 and IgG3 remains, courses of therapeutic plasmapheresis and immunoglobulin therapy are repeated throughout pregnancy.
EFFECT: method ensures prevention of development of severe forms of hemolytic disease of fetus and makes it possible to prolong pregnancy to terms of obtaining viable fetus due to stable reduction of titre of rhesus-antibodies and titre of IgG1 and IgG3 subclasses, as well as minimisation of probability of rebound-effect development as a result of combined application of therapeutic plasmapheresis and immunoglobulin therapy.
3 ex
