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Ronkin S - - 1989
Eight Rh-sensitized fetuses, between 21 weeks 2 days and 35 weeks of gestation, received 31 intravascular transfusions (13 exchange and 18 bolus) and one intraperitoneal transfusion under ultrasonographic guidance. The interval between transfusions was 13.4 +/- 4.7 days. Posttransfusion hematocrit dropped at a rate of 1.0% +/- 0.6% per day. ...
Kruskall M S - - 1989
Although fresh frozen plasma (FFP) prepared from autologous blood donated during pregnancy has frequently been given to homologous recipients at our institution, one transfusion resulted in an unanticipated diagnostic dilemma. A 31-year-old woman with disseminated intravascular coagulation of unclear etiology was transfused with multiple units of FFP, including 2 from ...
Harman C R - - 1989
The original description of intraperitoneal transfusion calls for contrast-dye infusion and X-ray confirmation of placement of the needle free in the peritoneal cavity. Ultrasound methods, using air or saline as contrast media, have been described to replace the X-rays. This report illustrates at least one way in which the ultrasound ...
Nicolini U - - 1989
Data from 99 intra-uterine transfusions performed in 30 patients (31 fetuses) with Rh allo-immunization have been reviewed. Mean gestational age at the first transfusion was 23.6 weeks and mean fetal haematocrit 19.8%. The number of procedures was on average 3.2 per fetus. Survival rate was 84%. Fifty-nine intravascular transfusions were ...
Bowman J M - - 1989
We report an instance of transfusion-induced anti-k so severe that three intrauterine intravascular fetal transfusions were required. The pretransfusion circulating hemoglobin level in the fetus was 60 g/l and hematocrit was 0.19. This, to our knowledge, is the first example of the rare alloantibody, anti-k, producing erythroblastosis so severe that ...
Pielet B W - - 1988
Fetal blood sampling via cordocentesis is being used with increasing frequency. Between March 1986 and February 1988, we performed 58 intravascular transfusions (64 attempts) and 27 fetal blood samplings (28 attempts) guided by ultrasonography. The complication rates for intravascular transfusion and fetal blood sampling were 9.4% (6 of 64) and ...
Nicolini U - - 1988
Seventy-one fetal blood samplings (FBS) were attempted from the intrahepatic portion of the umbilical vein (IHV) at 18-34 weeks; 54 were attempted primarily and 17 secondarily after a failed attempt at the placental cord insertion. Fetal blood was obtained in 89 per cent of the cases. Intravascular transfusion (IVT) was ...
Barss V A - - 1988
Twenty-two patients who had 23 pregnancies complicated by isoimmunization were managed by the use of intravascular methods on an outpatient basis. Nine patients underwent 30 percutaneous fetal blood sampling procedures to determine fetal blood type or hematocrit, without complication. Thirteen patients underwent 45 intrauterine fetal transfusions via the umbilical vessels ...
Mills L - - 1988
Fourteen mothers carrying ABO compatible but Rh D incompatible pregnancies experienced large feto-maternal haemorrhages (estimated 188 ml, range 50-400 ml red cells). These were all treated with infusions of fresh frozen plasma containing anti-D at a mean immunoglobulin to fetal cell ratio of 129 i.u. (25.8 micrograms)/ml of fetal cells. ...
Dunn P A - - 1988
Percutaneous umbilical blood sampling (PUBS) provides a new and exciting method for assessment and management of certain fetal disorders. This procedure offers direct access to the fetal circulation for obtaining blood samples or for transfusing the fetus in utero. Although investigational, PUBS offers treatment approaches that were not previously available. ...
Nimrod C - - 1988
The presence and elevation of atrial natriuretic peptide in fetuses has not previously been demonstrated. This study of right atrial pacing in fetal lambs demonstrated a threefold to fourfold increase in atrial natriuretic peptide during the production of fetal hydrops. Its rate of return to a normal level paralleled the ...
MacKenzie I Z - - 1988
Fifty-one pregnancies complicated by rhesus (D) isoimmunization have been managed by serial fetal blood sampling between 17 and 36 weeks gestation as an alternative to amniocentesis for delta OD453 measurements. In 36 pregnancies where the fetus was shown to be rhesus (D) positive and both measurements were made before any ...
Maxwell D J - - 1988
During 1980-7, 23 pregnancies of 22-38 weeks' duration were investigated for fetal tachycardia. Twelve were cases of supraventricular tachycardia, eight of atrial flutter, and three cases in which the rhythm varied between supraventricular tachycardia and atrial flutter. In 11 cases the fetus had developed non-immune fetal hydrops before referral; 12 ...
Kaplan C - - 1988
Neonatal alloimmune thrombocytopenia (NAIT) can cause severe bleeding in the central nervous system (CNS) and death or severe neurologic sequelae. The expression of the PLA1 antigen is detectable as early as 19 weeks of gestation. Alloimmunization can therefore lead to fetal thrombocytopenia very early in pregnancy. Until recently, we have ...
Shimokawa H - - 1988
Using ultrasound, nonimmunologic hydrops fetalis can be diagnosed antenatally, but the antenatal management remains debatable. To treat a fetus with idiopathic hydrops fetalis, we injected albumin into the fetal abdomen in utero. After this treatment, the hourly fetal urine production rate increased significantly, and edema and ascites disappeared subsequently at ...
Parer J T - - 1988
The diagnosis and treatment of isoimmunization has improved markedly with the introduction of high-resolution real-time ultrasound, cordocentesis, selective intravascular fetal blood transfusion, and meticulous fetal surveillance. There is reason to believe that with appropriate and timely management in severely isoimmunized patients, there may be a 90% or greater chance of ...
Nicolaides K H - - 1988
A reference range of fetal haemoglobin concentration (g/dl) was established from umbilical cord blood samples obtained by cordocentesis (n = 200) or at delivery (n = 10). In normal pregnancy the mean fetal haemoglobin increases linearly from 11 g/dl at 17 weeks' gestation to 15 g/dl at 40 weeks' gestation ...
Soothill P W - - 1988
1. The effect of anaemia and transfusion with adult blood on fetal 2,3-diphosphoglycerate levels was investigated by studying fetal blood from 45 normal pregnancies at 17-42 weeks of gestation and in 34 pregnancies complicated by erythroblastosis fetalis. 2. In normal fetuses, 2,3-diphosphoglycerate concentration was higher than in adults and did ...
Berkowitz R L - - 1988
Over a 27-month period 17 pregnancies in 16 patients with severe red blood cell isoimmunization were managed with intravascular transfusions performed in utero. Fourteen of these women were Rh negative and sensitized to D or to both D and C, and the remaining two patients were sensitized to the Kell ...
Grannum P A - - 1988
Seventy-two intrauterine intravascular transfusions were performed on 26 patients with severe erythroblastosis fetalis. Twenty of the 26 fetuses were hydropic at the time of referral. Of the 20 hydropic fetuses, 16 (80%) survived. Hydrops was completely reversed in 13 of the 16 fetuses (81%). Total protein of less than 3 ...
Westgren M - - 1988
Six patients with pregnancies of 19-31 weeks' duration showing evidence of erythroblastosis fetalis were treated with 25 fetal intracardiac blood transfusions. Complications related to the procedure occurred on five occasions in three patients. In two of the six patients the fetus died, but it was unlikely that death was related ...
Chitkara U - - 1988
Fetal hematocrit values of blood obtained by percutaneous umbilical blood sampling were correlated with ultrasound findings in 35 samples from 15 pregnancies undergoing evaluation for Rh or Kell sensitization. Intravascular fetal transfusion was performed after a low hematocrit was obtained on 29 of 35 occasions. All fetuses with sonographic evidence ...
Weiner C P - - 1988
Digitalization by direct intramuscular injection of the fetus successfully controlled supraventricular tachycardia at 24 weeks' gestation after more traditional intensive trials of transplacental therapy with digoxin, verapamil, and procainamide, either separately or in combination, had failed. The fetal pharmacokinetics were calculated from fetal blood samples obtained by cordocentesis. No clear ...
Ramahi A J - - 1988
The incidence of E hemoglobinopathies has been increasing in the United States. This is the first known case report of hemoglobin S/E in pregnancy. Management was based on the similarities of the S/E and S/beta-thalassemia hemoglobinopathies, and included partial exchange transfusion. Complications included fetal distress, congenital hydrocephalus, and cleft lip ...
Derfler K - - 1988
The successful outcome of a pregnancy complicated by reversible renal failure secondary to total ureteral obstruction caused by a pregnant uterus and treated temporarily with nephrostomy is reported. The cyclosporine A (CsA) and prednisone treated female recipient of a cadaveric renal allograft gave birth to a male child, which at ...
Shimokawa H - - 1988
Seven fetuses with idiopathic hydrops fetalis (IHF) were treated in utero by injecting albumin into the fetal abdominal cavity and by removal of accumulated fluid from the serous cavities. Signs of hydrops fetalis disappeared in utero in one, and skin edema significantly decreased in another. In the other five, signs ...
Lémery D - - 1988
Since 1984 we have performed 30 intrauterine exchange transfusions (IUET) under ultrasound guidance. In 4 pregnancies with anterior placenta, we performed 9 umbilical cord catheterizations in 11 IUET: the first with material for epidural analgesia and the others with a central venous catheter. The latest one was performed at 34 ...
Hogge W A - - 1988
Percutaneous umbilical blood sampling (cordocentesis) provides direct access to the fetal circulation in the second and third trimesters of pregnancy. Seventeen patients underwent this procedure between December 1985 and December 1986 for evaluation of a variety of clinical situations, including nonlethal fetal abnormalities detected by ultrasound, equivocal results of amniocentesis, ...
Westgren M - - 1988
A severely Rh-affected fetus with an initial hematocrit value of 7% and a hemoglobin value of 2.3 g/dl was transfused three times by the intravascular route into the umbilical cord under ultrasonic guidance. After the second transfusion, fetal movements recurred and the non-stress test became reactive. Neonatal outcome was favorable. ...
Leidig E - - 1988
Differential diagnosis of intrauterine hydrocephalus includes various types of cerebral malformations. In about 30% of cases the pathogenesis remains unknown. During 1983-1985 we diagnosed intrauterine posthaemorrhagic hydrocephalus (IPHH) in four newborns. In three of the reported cases intraventricular haemorrhage (IVH) could already be proven in the fetus. Due to these ...
Keidan A J - - 1988
Prophylactic exchange transfusion is of uncertain value in pregnancy complicated by sickle cell disease (SCD), and there is a lack of laboratory tests to monitor its effect and determine the optimal number and frequency of transfusions. In a prospective study of four consecutive pregnancies complicated by SCD, the product of ...
Bowell P J - - 1988
A study of maternal blood samples from 280,000 pregnancies in an 8-year period has shown 38 examples of anti-C (without anti-D) sensitization. This frequency (0.14/1000 pregnancies) was lower than that previously found for anti-c (0.63/1000 pregnancies) and for anti-D (2.55/1000 pregnancies). Although most of the 38 babies born to mothers ...
Copel J A - - 1988
Intravascular fetal transfusion can be complicated by difficulty in maintaining vascular access because of fetal movements. Treatment by intramuscular pancuronium bromide has been proposed as a means of arresting fetal movements, although this treatment requires a separate puncture for injection. We report in this article our experience with intravenous fetal ...
Kruskall M S - - 1987
Forty-eight women in the third trimester of pregnancy who requested autologous blood donations were enrolled in an experimental protocol to evaluate the safety of this procedure. Risk factors suggesting the possible need for postpartum transfusion were present in 17 women, including previous history of transfusion, scheduled cesarean section, placenta previa, ...
Socol M L - - 1987
The rhesus-sensitized fetus with the worst prognosis is one with early onset of hydropic changes. Percutaneous umbilical blood sampling now enables access to the fetal circulation and thereby allows more precise evaluation of fetal anemia and direct intravascular transfusion. A variation of this technique was used in three pregnancies complicated ...
Mackenzie I Z - - 1987
Ten fetuses, severely affected by Rhesus (D) haemolytic disease, received one to three intravascular blood transfusions at between 18 and 30 weeks gestation, with the use of fetoscopically guided needles into one of the umbilical cord vessels. Although the technique was successfully accomplished in all cases, the fetal response to ...
Moise K J KJ - - 1987
Advances in fetal therapy have led to the utilization of such techniques as intravascular transfusion of the Rh-affected fetus, bladder shunt placement in the fetus with obstructive uropathy, and percutaneous umbilical blood sampling. Fetal movement makes these procedures technically more difficult while increasing the risk of fetal injury. However, maternal ...
Soothill P W - - 1987
In 79 pregnancies with erythroblastosis fetalis, fetal blood was sampled to assess the level of anaemia. Significant correlations were found between the haemoglobin concentration and umbilical artery pH, bicarbonate concentration and base excess. Compensatory mechanisms help to maintain oxygen supply in anaemia but their failure is associated with hydrops fetalis.
Matsunaga Y - - 1987
During a large outbreak of erythema infectiosum in 1987 in Toyama prefecture, Japan, a 32-year-old woman acquired a mild rash on her arms and legs at 18 weeks of gestation. At 26 weeks and 4 days of gestation, the fetus died by hydrops fetalis and pregnancy was terminated. Histological studies ...
Vintzileos A M - - 1987
Described is a pregnancy complicated by severe Rh sensitization and hydrops fetalis which was managed aggressively with frequent intrauterine transfusions initiated at 21 1/2 weeks of gestation. No improvement or only temporary improvement of the fetal hydrops was observed after each intrauterine transfusion. Postmortem examination of the infant revealed the ...
Carrington D - - 1987
In 2 cases of hydrops fetalis and intrauterine death associated with human parvovirus B19 infection that produced very few symptoms during the second trimester of pregnancy, maternal serum alpha-fetoprotein levels were raised, before the ultrasonic detection of hydropic features. Fetal blood sampling in 1 case revealed the features of aplastic ...
Tuck S M - - 1987
An assessment of the benefits of prophylactic blood transfusion during 51 pregnancies in women with haemoglobin SS, haemoglobin SC and haemoglobin S-beta-thalassaemia in a retrospective study from 1978 to 1984 has failed to demonstrate any clear conclusions as to their efficacy. Of the transfused patients, 22% developed atypical red cell ...
Gilabert J - - 1987
A 27-year-old pregnant woman with severe congenital hypofibrinogenemia was studied from the 18th to the 40th week of pregnancy, after which she had a normal delivery. The results of the quantitative and qualitative fibrinogen studies done on the patient made it possible to rule out associated dysfibrinogenemia. No variations in ...
Piiroinen O - - 1987
Intrauterine intravascular transfusion is the most effective way of correcting the fetal haemoglobin level in severe rhesus haemolytic disease. Fetal anaemia should be corrected as early as possible before the development of hydrops and ascites. When required, the transfusion can be repeated several times. We present in this publication our ...
Fagiolo E - - 1987
We investigated metabolic, blood gas and acid-base balance modifications of erythrocyte concentrates resuspended in PAGGS-sorbitol solution during 6 weeks of storage. Glucose utilization was impaired during the last 2 weeks, while the intraerythrocytic ATP level decreased only 50% from the 1st to the 6th week. The K+ and Hb concentration ...
Erkkola R - - 1987
HELLP syndrome is a triad of hemolysis, elevated liver enzymes and low platelet count during pregnancy and it is proposed to be a sign of severe preeclampsia. We present two mothers with this life-threatening condition. In the first case, the syndrome appeared after a twin delivery at 34 weeks of ...
LoziƄska D - - 1987
The results of treatment with intrauterine transfusion are presented. The analysis comprised 48 successful transfusions into 29 foetuses. The reference group consisted of 11 transfusions which proved nonfeasible or ineffective and 54 untreated cases. Following blood treatment, the newborn mortality rate dropped more than threefold. Long-term follow-up of 21 children ...
Younis J - - 1986
A case of rhesus isoimmunization with spontaneous improvement in severity of erythroblastosis with advancing parity is presented. The isoimmunized pregnant woman after having 3 perinatal deaths all due to severe hydrops fetalis, subsequently delivered 2 Rh-positive surviving infants. In her last pregnancy, the timing of delivery was indicated by cessation ...
Bowell P J - - 1986
In an 8-year period, 177 of 280,000 pregnancies were complicated by maternal anti-c alloimmunization. Although there was one neonatal death associated with anti-c haemolytic disease of the newborn, only two infants were severely anaemic at birth. A total of 11 babies required exchange transfusion, but nine of these developed hyperbilirubinaemia ...
Benacerraf B R - - 1986
A case of diaphragmatic hernia is reported where the prenatal diagnosis was made sonographically in a hydropic fetus and the large associated fluid collection in the right side of the chest was aspirated in utero. Almost complete drainage of the chest and abdominal fluid was accomplished, with resolution of the ...
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