Intraperitoneal transfusion for severe, early-onset rhesus disease requiring treatment before 20 weeks of gestation: A consecutive case series

Crawford, Natalie E.H.; Parasuraman, R; Howe, David

doi:10.1016/j.ejogrb.2019.10.027

Cited by 6 publications

(1 citation statement)

References 11 publications

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“…Intravenous transfusions are performed by transfusing blood into the umbilical vein either at the placental cord insertion, the intrahepatic portion of the umbilical vein, or the umbilical vein in a free loop of cord, although the last option is associated with higher complications [5]. IPT has been found to be less effective than IVT, especially in cases of fetal hydrops and is typically performed in cases where the umbilical vein is not accessible such as early gestational age (GA) [6][7][8]. Some centers perform a combination of IVT and IPT to potentially increase the interval between subsequent transfusions [9,10].…”

Section: Introductionmentioning

confidence: 99%

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Donepudi,

Jouannic,

Maisonneuve

et al. 2023

Fetal Diagn Ther

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Introduction: Fetal anemia from hemolytic disease treated by intrauterine transfusion (IUT) can be performed by intraperitoneal, intracardiac and intravascular transfusion (IVT). Objective of our study was to compare different transfusion techniques. Methods: Retrospective review of IUT secondary to red cell alloimmunization at eight international centers from 2012-2020. Severe anemia suspected if middle cerebral artery peak systolic velocity  1.5 MoM. Demographic, delivery and postnatal variables were analyzed. Results: Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs 15.8%, p=0.7), prior pregnancy IUT (25.6 vs 31.6%, p=0.5) or neonatal transfusion (36.1 vs 43.8%, p=0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p=0.03), lower starting hematocrit (13.3% (±6) vs. 17.7% (±8.2), p = 0.04) and trend towards lower gestational age (24.6 (20.1-27) vs. 26.4 (23.2-29.6) weeks, p=0.08). No difference in birthweight, neonatal phototherapy, exchange or simple transfusion. Conclusion: This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops and lower starting hematocrit was seen. Neither technique affected outcomes. This study may suggest that physician’s experience may be the strongest contributor of outcomes.

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Section: Introductionmentioning

confidence: 99%

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Donepudi,

Jouannic,

Maisonneuve

et al. 2023

Fetal Diagn Ther

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Genetic Amniocentesis, Chorionic Villus Sampling, Intrauterine Transfusion, and Shunts

McHugh,

Miller

2023

Queenan's Management of High‐Risk Pregnancy

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Prenatal parvovirus B19 infection

Kagan,

Hoopmann,

Geipel

et al. 2024

Arch Gynecol Obstet

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Parvovirus B19 (B19V) causes erythema infectiosum, a.k.a., fifth disease. This disease primarily affects children. It is generally self-limiting and subsides after 1–2 weeks. In pregnancy, the virus can cross the placenta and result in a fetal infection. This may lead to severe fetal anemia, hydrops fetalis, a miscarriage, or intrauterine fetal death. The risk of long-term sequelae also appears to be increased. About one-third of pregnant women are not immune to B19V and, therefore, are at risk to contract a primary infection. The seroconversion rate during pregnancy is generally around 1–2%. During a primary infection, maternal–fetal transplacental transmission of B19V occurs in about 30–50% of the cases and the risk of fetal infection increases with advancing gestational age. The risk of severe fetal anemia or hydrops is around 3–4% overall and is around 6–7% if the primary infection occurs before 20 weeks’ gestation. Fetal monitoring in women with a primary B19V infection includes regular ultrasound examinations looking for evidence of hydrops fetalis and Doppler measurements of the middle cerebral artery peak velocity. Fetal blood sampling is performed if a significant anemia is suspected and, if such is found, an intrauterine blood transfusion is needed. This article provides an overview of the epidemiology, pathogenesis, clinical manifestations, diagnostic methods, and management of B19V infection during pregnancy.

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Intraperitoneal transfusion for severe, early-onset rhesus disease requiring treatment before 20 weeks of gestation: A consecutive case series

Cited by 6 publications

References 11 publications

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion

Genetic Amniocentesis, Chorionic Villus Sampling, Intrauterine Transfusion, and Shunts

Prenatal parvovirus B19 infection

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