Whitington PF, et al. – This article is written with the objective to ascertain the efficacy of this approach in a large cohort of women at risk for poor pregnancy outcome because of gestational alloimmune liver disease (GALD). The current study showed that antenatal therapy with high–dose intravenous immunoglobulin (IVIG) initiated at either 18 or 14 gestational weeks effectively prevents the poor outcome of pregnancies at risk for GALD.

Methods

• Women with a history of influenced offspring were provided antenatal IVIG treatment and information were obtained prospectively from 1997 to 2015.
• The outcomes of treated pregnancies were compared to those of untreated pregnancies, and the efficacy of starting at 14 weeks was compared to that of starting at 18 weeks.

Results

• In this study, a total of 188 treated pregnancies in 151 women were examined.
• Only 30% (n = 105) of untreated gestations resulted in healthy offspring as compared to 94% (n = 177) of treated pregnancies (p< 0.0001).
• Treated gestations of both the 14–week (n = 108) and the 18–week (n = 80) start cohort demonstrated a reduced rate of fetal loss relative to untreated gestations (p < 0.0001).
• Equivalent outcomes were recorded in the 18–week versus the 14–week start cohort (p > 0.05).
• In this study, they observed few adverse events or complications of antenatal therapy.