Document Detail

Sonographic demonstration of brain injury in fetuses with severe red blood cell alloimmunization undergoing intrauterine transfusions.
MedLine Citation:
PMID:  15133789     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess sonographically brain anatomy in fetuses with severe anemia due to red blood cell alloimmunization undergoing intrauterine intravascular transfusions. METHODS: Multiplanar neurosonography was performed in seven consecutive hydropic fetuses undergoing intrauterine transfusions (mean gestational age 22 +/- 2.5 weeks; mean hemoglobin concentration at the first transfusion 2.3 +/- 1.0 g/dL). RESULTS: Abnormal cerebral findings were identified in four out of seven fetuses. An intracerebellar hemorrhage developed in two fetuses after the first transfusion and one fetus that had severe brain edema before the first transfusion was later found to have cystic periventricular leukomalacia. In one fetus unilateral ventriculomegaly was noted after the first transfusion. Two fetuses were terminated. The remaining pregnancies had an uneventful course, the infants were delivered between 34 and 36 gestational weeks and were alive and well at the time of writing. Prenatal diagnosis of brain injury was always confirmed except for the case with ventriculomegaly that underwent spontaneous intrauterine resolution. CONCLUSIONS: Fetuses with extreme anemia due to red blood cell alloimmunization can be salvaged by intrauterine transfusion. In some of these cases brain injury may occur prenatally, and the risk seems to be particularly high when the hemoglobin concentration at the time of the first transfusion is <or= 2 g/dL. We suggest that in these pregnancies detailed fetal neuroimaging by either multiplanar sonography and/or magnetic resonance imaging is indicated.
T Ghi; L Brondelli; G Simonazzi; B Valeri; D Santini; F Sandri; G Ancora; G Pilu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology     Volume:  23     ISSN:  0960-7692     ISO Abbreviation:  Ultrasound Obstet Gynecol     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-10     Completed Date:  2004-09-07     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9108340     Medline TA:  Ultrasound Obstet Gynecol     Country:  England    
Other Details:
Languages:  eng     Pagination:  428-31     Citation Subset:  IM    
Copyright Information:
Copyright 2004 ISUOG. Published by John Wiley & Sons, Ltd.
Department of Obstetrics and Gynecology, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy.
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MeSH Terms
Abortion, Therapeutic
Blood Transfusion, Intrauterine*
Brain / abnormalities*
Cerebral Hemorrhage / etiology,  ultrasonography
Erythroblastosis, Fetal / complications,  therapy*,  ultrasonography
Gestational Age
Infant, Newborn
Pregnancy Outcome
Ultrasonography, Prenatal

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