PMC10127454_01
The fluctuations of MoM during the whole treatment course (case 1). The yellow arrows denote the DFPP treatment session. The red arrows indicate IUT.
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F1
A total of 9 cycles of DFPP were administered between 14 and 20 weeks of gestation (Figure 1).
The changes of IgG-D, (A), and (B) antibodies during DFPP treatment (case 1). (A) The change of IgG-D titers and the comparison of IgG-D titers pre- and post- DFPP treatment. (B) The change of IgG-A titers and the comparison of IgG-A titers pre- and post- DFPP treatment. (C) The change of IgG-B titers and the comparison of IgG-B titers pre- and post- DFPP treatment. odd numbers represent pre-DFPP. ns, not significant.
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F2
DFPP treatment, anti-D IgG antibody was removed from the serum, along with other IgG (anti-A and anti-B) (Figure 2) and IgM (anti-A and anti-B) antibodies (Supplementary Material 1). During the whole treatment period, the titers of anti-D stayed between 512 and 1,024 and MCA-PSV stayed below 1.5 MoM until 20 weeks of gestation before IUT.
(A-D) Comparison of the changes in blood routine and protein levels pre- and post-DFPP treatment (case 1). *p < 0.05; **p < 0.01; ns, not significant.
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F3
Additionally, other proteins, such as albumins, globulins, and coagulation factors, decreased after DFPP treatment, while blood routine did not (Figure 3).
(A-D) the fluctuations of blood routine and protein level over the whole treatment period (case 1). Odd numbers represent pre-DFPP. Reference range: WBC, 3.5-9.5*109/L; NEU, 1.8-6.3*109/L; LYM, 1.1-3.2*109/L; Hb, 115-150 g/L; Alb, 40-55 g/L; Glb, 20-40 g/L; IgA, 0.7-4.0 g/L; IgG, 7-16 g/L; IgM, 0.4-2.3 g/L; C3, 0.9-1.8 g/L; C4, 0.1-0.4 g/L; kappa, 1.7-3.7 g/L; lambda, 0.9-2.1 g/L; factor II, 70-100 (%); factor V, 70-120 (%); factor VII, 70-120 (%); factor VIII, 70-150 (%); factor IX, 70-120 (%); factor X, 70-120 (%); factor XI, 70-120 (%); factor XII 70-150 (%).
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F4
However, coagulation factors rebounded to the normal level on the next day and albumin was still above 30 g/L (Figure 4); therefore, protein supplements were not needed.
PMC10127454_02