Document Detail


Treatment of fetal anemia due to red-cell alloimmunization with intrauterine transfusions in the Netherlands, 1988-1999.
MedLine Citation:
PMID:  15255845     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess pregnancy outcome after intrauterine transfusion (IUT) for fetal anemia due to red-cell alloimmunization in the Netherlands over 11 years, in order to improve care and counseling. METHODS: A retrospective cohort study was conducted from January 1, 1988, to January 1, 1999. Data were collected prospectively on all red-cell alloimmunized pregnancies requiring intrauterine blood transfusions. Primary outcome variables were fetal and neonatal survival in relation to the type of antibody, gestational age and presence or absence of hydrops. In addition, we studied short-term neonatal morbidity and procedure-related complications. RESULTS: A total of 210 fetuses from 208 pregnancies received 593 transfusions. Overall survival rate was 86%. Survival of hydropic fetuses (78%) was significantly different from those without hydrops (92%). Low survival rates were especially found in hydropic fetuses with the first transfusion at gestational ages of 20 weeks or less (55%) or between 28 and 32 weeks (59%). In maternal rhesus D [Rh(D)] immunization 89% of fetuses survived, whereas survival in the case of Kell immunization was 58%. All fetuses with anemia due to Rh(c) immunization survived. The overall fatal procedure-related complication rate was 1.7% per procedure, resulting in a fetal loss rate of 4.8%. CONCLUSIONS: Intrauterine intravascular transfusions are effective in the management of fetal alloimmune anemia. Fetal hydrops, mostly associated with late referral, decreases the chance of survival. To improve the outcome of red-cell alloimmunized pregnancies early diagnosis of fetal anemia and referral to a specialized center are important, enabling the start of treatment before hydrops develops.
Authors:
Inge L van Kamp; Frans J C M Klumper; Robertjan H Meerman; Dick Oepkes; Sicco A Scherjon; Humphrey H H Kanhai
Related Documents :
2750095 - Passive transfusion of human chorionic gonadotropin from plasma donated during pregnancy.
9790385 - Management of parvovirus infection in pregnancy and outcomes of hydrops: a survey of me...
6284295 - Maternal anti-d concentrations and outcome in rhesus haemolytic disease of the newborn.
23111205 - Accurate prediction of pregnancy viability by means of a simple scoring system.
11100305 - Ovulation induction.
16176515 - Placenta percreta with subsequent uterine rupture at 15 weeks of gestation after two pr...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acta obstetricia et gynecologica Scandinavica     Volume:  83     ISSN:  0001-6349     ISO Abbreviation:  Acta Obstet Gynecol Scand     Publication Date:  2004 Aug 
Date Detail:
Created Date:  2004-07-16     Completed Date:  2004-08-26     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370343     Medline TA:  Acta Obstet Gynecol Scand     Country:  Denmark    
Other Details:
Languages:  eng     Pagination:  731-7     Citation Subset:  IM    
Affiliation:
Department of Obstetrics, Fetal Medicine Unit, Leiden University Medical Center, Leiden, The Netherlands. I.L.van_Kamp@lumc.nl
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Blood Transfusion, Intrauterine*
Cohort Studies
Erythroblastosis, Fetal / epidemiology*,  mortality,  therapy*
Female
Gestational Age
Humans
Infant, Newborn
Netherlands / epidemiology
Pregnancy
Pregnancy Outcome
Prospective Studies
Retrospective Studies
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  The decidual suction method: a new way of collecting decidual tissue for functional and morphologica...
Next Document:  Anterior placenta percreta: surgical approach, hemostasis and uterine repair.