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patients treated after 28 weeks' gestation and three out of 12 patients treated before 28 weeks' gestation. This highlights the problem of severe disease early in pregnancy, when intrauterine transfusion remains extremely hazardous, yet plasmapheresis alone even using a cell separator to exchange over 20 1 a week may fail to control the rate of fetal haemolysis. Several points have emerged from our study of patients with exceptionally severe rhesus disease treated by intensive plasmapheresis with a cell separator. Firstly, the expected rise in anti-D level as pregnancy progresses can be prevented. Concentrations in seven of our eight patients actually fell (P
patients treated after 28 weeks' gestation and three out of 12 patients treated before 28 weeks' gestation. This highlights the problem of severe disease early in pregnancy, when intrauterine transfusion remains extremely hazardous, yet plasmapheresis alone even using a cell separator to exchange over 20 1 a week may fail to control the rate of fetal haemolysis. Several points have emerged from our study of patients with exceptionally severe rhesus disease treated by intensive plasmapheresis with a cell separator. Firstly, the expected rise in anti-D level as pregnancy progresses can be prevented. Concentrations in seven of our eight patients actually fell (P
