The reversal of hydrops fetalis by intravascular intrauterine transfusion in severe isoimmune fetal anemia.

Abstract

Seventy-two intrauterine intravascular transfusions were performed on 26 patients with severe erythroblastosis fetalis. Twenty of the 26 fetuses were hydropic at the time of referral. Of the 20 hydropic fetuses, 16 (80%) survived. Hydrops was completely reversed in 13 of the 16 fetuses (81%). Total protein of less than 3 gm/dl, albumin less than 2 gm/dl, and a hematocrit level of less than 15% were associated with hydrops fetalis. After hydrops was reversed, total protein greater than 3 gm/dl, albumin greater than 2 gm/dl, along with a sustained hematocrit level of greater than 15%, were found. Only three neonates were born with minimal ascites, two of whom had had intraperitoneal transfusions before intravascular treatments. There were 21 survivors of the total group, giving an overall survival rate of 82%. There was one neonatal death from severe respiratory distress syndrome. Thirty-eight percent of the neonates did not require exchange transfusions in the newborn period. Intrauterine intravascular transfusions appear to be an effective mode of therapy in severe erythroblastosis fetalis and not only increase survival rates but also decrease neonatal morbidity and mortality.

• Authors: P A Grannum, J A Copel, F R Moya, A L Scioscia, J A Robert, H N Winn, B C Coster, C B Burdine, J C Hobbins
• Journal: American journal of obstetrics and gynecology (Am J Obstet Gynecol) Vol. 158 Issue 4 Pg. 914-9 (Apr 1988) ISSN: 0002-9378 [Print] United States
• PMID: 3284364 (Publication Type: Journal Article)

Chemical References

• Blood Proteins
• Serum Albumin

Topics

• Adult
• Birth Weight
• Blood Proteins (analysis)
• Blood Transfusion, Intrauterine
• Edema (therapy)
• Erythroblastosis, Fetal (therapy)
• Female
• Fetal Diseases (therapy)
• Fetal Monitoring
• Gestational Age
• Hematocrit
• Humans
• Infant, Newborn
• Pregnancy
• Serum Albumin (analysis)
• Ultrasonography