OBJECTIVE: This study was undertaken to test the hypothesis that the degree of immune fetal hydrops predicts outcome in red blood cell-alloimmunized pregnancies. STUDY DESIGN: In an 11-year period, 213 fetuses received 599 intrauterine transfusions. The outcome of 208 pregnancies, including two pairs of twins, was analyzed in a retrospective study. Eighty fetuses demonstrated ultrasonographic signs of hydrops at the start of treatment; 42 of these were classified as mildly hydropic and 38 were classified as severely hydropic. Reversal of hydrops as a result of treatment, survival, and neonatal morbidity was studied. RESULTS: The overall survival rate of fetuses with hydrops was 78%. Of the fetuses with mild hydrops, 98% survived, whereas in cases of severe hydrops the survival rate was 55%. Intrauterine reversal of hydrops occurred in 65% of the fetuses with hydrops. The reversal rate was 88% in fetuses with mild hydrops and 39% in fetuses classified as severely hydropic. After reversal of hydrops, almost all of the fetuses survived (98%), whereas in cases of persistent hydrops outcome was unfavorable, with a survival rate of 39% for all fetuses and 26% for fetuses classified as severely hydropic. CONCLUSION: In contrast with severe hydrops, there is a high rate of reversal of mild hydrops after adequate treatment. In our study 98% of fetuses survived after reversal of hydrops. To improve the outcome of red blood cell-alloimmunized pregnancies, early diagnosis of fetal anemia and referral to a specialized center are important; these steps enable the start of intrauterine treatment when hydrops is absent or still mild.
OBJECTIVE: This study was undertaken to test the hypothesis that the degree of immune fetal hydrops predicts outcome in red blood cell-alloimmunized pregnancies. STUDY DESIGN: In an 11-year period, 213 fetuses received 599 intrauterine transfusions. The outcome of 208 pregnancies, including two pairs of twins, was analyzed in a retrospective study. Eighty fetuses demonstrated ultrasonographic signs of hydrops at the start of treatment; 42 of these were classified as mildly hydropic and 38 were classified as severely hydropic. Reversal of hydrops as a result of treatment, survival, and neonatal morbidity was studied. RESULTS: The overall survival rate of fetuses with hydrops was 78%. Of the fetuses with mild hydrops, 98% survived, whereas in cases of severe hydrops the survival rate was 55%. Intrauterine reversal of hydrops occurred in 65% of the fetuses with hydrops. The reversal rate was 88% in fetuses with mild hydrops and 39% in fetuses classified as severely hydropic. After reversal of hydrops, almost all of the fetuses survived (98%), whereas in cases of persistent hydrops outcome was unfavorable, with a survival rate of 39% for all fetuses and 26% for fetuses classified as severely hydropic. CONCLUSION: In contrast with severe hydrops, there is a high rate of reversal of mild hydrops after adequate treatment. In our study 98% of fetuses survived after reversal of hydrops. To improve the outcome of red blood cell-alloimmunized pregnancies, early diagnosis of fetal anemia and referral to a specialized center are important; these steps enable the start of intrauterine treatment when hydrops is absent or still mild.
Authors: Edi Vaisbuch; Roberto Romero; Ricardo Gomez; Juan Pedro Kusanovic; Shali Mazaki-Tovi; Tinnakorn Chaiworapongsa; Sonia S Hassan Journal: J Matern Fetal Neonatal Med Date: 2010-08-11
Authors: Arwa Z Al-Riyami; Mouza Al-Salmani; Sabria N Al-Hashami; Sabah Al-Mahrooqi; Ali Al-Marhoobi; Sumaiya Al-Hinai; Saif Al-Hosni; Sathiya M Panchatcharam; Zainab A Al-Arimi Journal: Sultan Qaboos Univ Med J Date: 2018-04-04
Authors: Edward R Kabyemela; Michal Fried; Jonathan D Kurtis; Gwamaka Moses; J Patrick Gorres; Atis Muehlenbachs; Patrick E Duffy Journal: Front Immunol Date: 2021-04-30 Impact factor: 7.561
Authors: S A Pasman; L Claes; L Lewi; D Van Schoubroeck; A Debeer; M Emonds; E Geuten; L De Catte; R Devlieger Journal: Facts Views Vis Obgyn Date: 2015