Prevention of Gestational Alloimmune Liver Disease by Intravenous Immunoglobulin Administration in the Second Trimester: A Presentation of Two Cases

Gestational alloimmune liver disease (GALD) is characterized by complement-mediated hepatocyte damage by transplacental transmission of maternal antibodies against fetal hepatocyte antigens. GALD's recurrence occurs up to 90% in pregnancies after an affected pregnancy. Intravenous immunoglobulin (IVIG) is a sterile, purified immunoglobulin (IgG) product that is manufactured from pooled human plasma. IVIG typically contains more than 95% unmodified IgG which has intact fragment crystallizable-dependent effector functions in addition to trace amounts of IgA and/or IgM. Indeed, antenatal high-dose IVIG treatment effectively reduces the risk of recurrence. In the present study, we reported two cases with GALD recurrence which was prevented by maternal IVIG administration in the second trimester.