Successful treatment of extremely severe fetal anemia due to Kell alloimmunization

Obstet Gynecol. 2002 Nov;100(5 Pt 2):1102-5. doi: 10.1016/s0029-7844(02)02143-9.


Background: Repeated plasmapheresis was used to prevent fetal death from severe anti-Kell alloimmunization until intrauterine transfusions were feasible.

Case: Repeated maternal plasma exchanges (N = 40) beginning at 7 weeks' gestation were used to treat severe anti-Kell alloimmunization. Ultrasound examination at 19 weeks' gestation revealed diffuse hydrops in this fetus (umbilical venous hemoglobin, 1.2 g/dL), which then required nine intrauterine transfusions through 34 weeks. A healthy 3840-g girl was delivered by cesarean delivery at 36 weeks. Despite aplastic anemia during the first 3 months of life, she is healthy and has no observable abnormalities at age 8.

Conclusion: A highly aggressive course of plasmapheresis and intrauterine transfusions can successfully treat fetal anemia caused by anti-Kell alloimmunization even when fetal hemoglobin is extremely low.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Blood Transfusion, Intrauterine*
  • Erythroblastosis, Fetal / therapy*
  • Female
  • Humans
  • Infant, Newborn
  • Kell Blood-Group System*
  • Plasmapheresis*
  • Pregnancy


  • Kell Blood-Group System