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Promethazine Hydrochloride Therapy in Severely Rh-Sensitized Pregnancies

Seventeen severely Rh-sensitized women were treated with promethazine hydrochloride (Phenergan) in 18 pregnancies, according to a protocol described by Gusdon et al. There was an unequivocal amelioration of the disease process in 10 of the pregnancies. In 9 of these 10 pregnancies, the infant survived. In 4 of the pregnancies, promethazine proved an unnecessary therapy as the infants were Rh negative. Promethazine may or may not have been helpful in 2 pregnancies, both of which resulted in live-born infants. One pregnancy resulted in intrauterine fetal death subsequent to an intrauterine transfusion. This infant was later shown to have multiple congenital anomalies incompatible with life. In a subsequent pregnancy, the mother was again treated with promethazine and had a normal infant who survived after exchange transfusions. The one loss of a live-born infant resulted from a cardiac arrest during an exchange transfusion. On the basis of these observations, the authors agree with Gusdon et al that promethazine does have an ameliorating effect on Rh-sensitized pregnancies.