The scope of prenatal therapy in severe rhesus hemolytic disease.

Prenatal blood transfusion of a fetus established anemia due to rhesus hemolytic disease can be life saving. In Hamburg-Eppendorf 252 transfusions in 130 babies have so far been carried out. The success rate was 51%. Out of 39 babies who had ascites at the time of the first transfusion, 13 survived. The amount of ascites aspirated at the first transfusion correlates with the prognosis: The chance of producing a living and healthy child is greater when the amount of ascites is under 5 mls than when it is over 5 mls. Babies with amniotic fluid bilirubin values from 0.4 to 0.6 still have a good chance of survival, whereas the prospects of success with values over 0.6 are very small. The technical risk of prenatal transfusion before the 27th week amounts, according to our observations, to about 6%.