Dipika Deka1, Vatsla Dadhwal2, Aparna K Sharma1, Unnati Shende1, Sumita Agarwal1, Ramesh Agarwal1, Perumal Vanamail1. 1. Department of Obstetrics and Gynecology and Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. 2. Department of Obstetrics and Gynecology and Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. vatslad@hotmail.com.
Abstract
OBJECTIVES: To study the perinatal survival and procedure-related (PR)complications after intrauterine transfusions in red cell alloimmunization. METHODS: Prospective data of 102 women with Rh-alloimmunized pregnancy undergoing intrauterine intravascular transfusion for fetal anemia, from January 2011 to October 2014 were analyzed. Main outcome measures were perinatal survival and procedure-related (PR) complications. RESULTS: A total of 303 intrauterine transfusions were performed in 102 women. Of 102 fetuses, 22 were hydropic at first transfusion. The mean period of gestation and hematocrit at first transfusion was 26.9 ± 3.3 weeks (range 19.7-33.8 weeks) and 17 ± 7.82 % (range 5.7-30 %), respectively. Average number of transfusions was 2.97 (range 1-7) per patient. Overall survival was 93 % and mean period of gestation at delivery was 34.5 ± 1.94 (range 28.3-37.4) weeks. Mean hematocrit at delivery was 36.9 ± 8.77 % (range 10-66 %). Fetal death occurred in four cases (3PR), neonatal death occurred in three cases (2PR). Emergency cesarean delivery after transfusion was performed in four pregnancies. The total PR complication rate was 2.97 %, resulting in overall PR loss in 1.65 % per procedure. CONCLUSION: Our results compare favorably with other studies published in the literature. Intravascular transfusion is a safe procedure improving perinatal survival in fetuses with anemia due to Rh-alloimmunization.
OBJECTIVES: To study the perinatal survival and procedure-related (PR)complications after intrauterine transfusions in red cell alloimmunization. METHODS: Prospective data of 102 women with Rh-alloimmunized pregnancy undergoing intrauterine intravascular transfusion for fetal anemia, from January 2011 to October 2014 were analyzed. Main outcome measures were perinatal survival and procedure-related (PR) complications. RESULTS: A total of 303 intrauterine transfusions were performed in 102 women. Of 102 fetuses, 22 were hydropic at first transfusion. The mean period of gestation and hematocrit at first transfusion was 26.9 ± 3.3 weeks (range 19.7-33.8 weeks) and 17 ± 7.82 % (range 5.7-30 %), respectively. Average number of transfusions was 2.97 (range 1-7) per patient. Overall survival was 93 % and mean period of gestation at delivery was 34.5 ± 1.94 (range 28.3-37.4) weeks. Mean hematocrit at delivery was 36.9 ± 8.77 % (range 10-66 %). Fetal death occurred in four cases (3PR), neonatal death occurred in three cases (2PR). Emergency cesarean delivery after transfusion was performed in four pregnancies. The total PR complication rate was 2.97 %, resulting in overall PR loss in 1.65 % per procedure. CONCLUSION: Our results compare favorably with other studies published in the literature. Intravascular transfusion is a safe procedure improving perinatal survival in fetuses with anemia due to Rh-alloimmunization.
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: Carolien Zwiers; Dick Oepkes; Enrico Lopriore; Frans J Klumper; Masja de Haas; Inge L van Kamp Journal: Prenat Diagn Date: 2018-09-27 Impact factor: 3.050