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Accumulation of Fetal IgG in Immunoglobulin Injection into the Fetal Abdominal Cavity Is Proven

Objective: There have been a number of studies on immunoglobulin injection into fetuses or mothers during pregnancy for the treatment of congenital cytomegalovirus infection. However, no study has examined the effect of injected immunoglobulin on fetal hemodynamics. In this study, we examined the effect of immunoglobulin injection on fetal hemodynamics by retrospectively measuring the concentrations of several IgG subclasses in stored umbilical cord blood sera collected during fetal therapy. Methods: Five patients who underwent immunoglobulin injection into the fetal abdominal cavity (IFAC) as a fetal therapy during pregnancy were included in this study. Frozen-stored umbilical venous blood samples collected from these patients during IFAC were measured for serum concentrations of each IgG subclass. Results: The largest change was observed in the IgG2 concentration, with a mean increase of 221% following IFAC. The IgG4 concentration also showed a mean increase of 63%. In contrast, the concentration of IgG1, which has the strongest physiological activity of all IgG subclasses examined, only exhibited an overall mean increase of 1.4%. Conclusion: Our results confirmed that immunoglobulins are incorporated into the fetal circulation following IFAC.