OBJECTIVE: The purpose of this study was to establish the true procedure-related complication rate of intrauterine transfusion therapy. STUDY DESIGN: A cohort study of 254 fetuses treated with 740 intrauterine blood transfusions for red-cell alloimmunization in a single center in the years 1988 to 2001. Our database was searched for perinatal deaths, emergency deliveries, infections, and preterm rupture of membranes associated with intrauterine blood transfusion. Complications were categorized by two independent obstetricians as procedure-related (PR) or not procedure-related (NPR). Logistic regression analysis was used to identify risk factors for complications. RESULTS: Overall survival was 225/254 (89%). Fetal death occurred in 19 cases (7 PR) and neonatal death in 10 cases (5 PR). There were two cases of intrauterine infection with Escherichia coli (both PR) and two other cases of preterm premature rupture of membranes (1 PR) within a week of a procedure. Emergency delivery after a transfusion was performed in 18 pregnancies (15 PR). The total PR complication rate was 3.1%, resulting in an overall PR loss rate of 1.6% per procedure. Arterial puncture, transamniotic cord puncture, refraining from fetal paralysis, and advancing gestational age were associated with the occurrence of PR complications. CONCLUSION: Our study shows that intrauterine transfusion is a safe procedure, with a relatively low PR perinatal loss rate. Arterial puncture and transamniotic cord needling carry a high risk for serious complications, whereas fetal paralysis improves the safety of the procedure. This information on risks of intrauterine transfusion therapy may help to further improve the safety of intrauterine transfusions. Data on complication rates of intrauterine transfusions are essential in counseling patients.
OBJECTIVE: The purpose of this study was to establish the true procedure-related complication rate of intrauterine transfusion therapy. STUDY DESIGN: A cohort study of 254 fetuses treated with 740 intrauterine blood transfusions for red-cell alloimmunization in a single center in the years 1988 to 2001. Our database was searched for perinatal deaths, emergency deliveries, infections, and preterm rupture of membranes associated with intrauterine blood transfusion. Complications were categorized by two independent obstetricians as procedure-related (PR) or not procedure-related (NPR). Logistic regression analysis was used to identify risk factors for complications. RESULTS: Overall survival was 225/254 (89%). Fetal death occurred in 19 cases (7 PR) and neonatal death in 10 cases (5 PR). There were two cases of intrauterine infection with Escherichia coli (both PR) and two other cases of preterm premature rupture of membranes (1 PR) within a week of a procedure. Emergency delivery after a transfusion was performed in 18 pregnancies (15 PR). The total PR complication rate was 3.1%, resulting in an overall PR loss rate of 1.6% per procedure. Arterial puncture, transamniotic cord puncture, refraining from fetal paralysis, and advancing gestational age were associated with the occurrence of PR complications. CONCLUSION: Our study shows that intrauterine transfusion is a safe procedure, with a relatively low PR perinatal loss rate. Arterial puncture and transamniotic cord needling carry a high risk for serious complications, whereas fetal paralysis improves the safety of the procedure. This information on risks of intrauterine transfusion therapy may help to further improve the safety of intrauterine transfusions. Data on complication rates of intrauterine transfusions are essential in counseling patients.
Authors: Katherine A Birchenall; Sebastian E Illanes; Francisco Lopez; Timothy Overton; Rachel Liebling; Peter W Soothill; Sherif Abdel-Fattah; Mark Denbow Journal: Blood Transfus Date: 2013-07-19 Impact factor: 3.443
Authors: Lindsay S Hall; Andrew M Hall; Wendy Pickford; Mark A Vickers; Stanislaw J Urbaniak; Robert N Barker Journal: Haematologica Date: 2014-01-17 Impact factor: 9.941
Authors: Mônica Deolindo Santiago; Cezar Alencar de Lima Rezende; Antônio Carlos Vieira Cabral; Henrique Vitor Leite; Gabriel Costa Osanan; Zilma Silveira Nogueira Reis Journal: Blood Transfus Date: 2010-10 Impact factor: 3.443
Authors: S D Joy; R O'Shaughnessy; N Schlabritz-Loutsevitch; M M Leland; P Frost; P Fan-Havard Journal: J Med Primatol Date: 2009-04-05 Impact factor: 0.667
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