Pulsed Doppler flow‐velocity waveforms before and after intrauterine intravascular transfusion for severe erythroblastosis fetalis

Copel, J.A.; Pa, Grannum; Belanger, Kathy

doi:10.1016/0020-7292(89)90493-1

Cited by 5 publications

(5 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Intracardiac and peripheral Doppler wave forms may be used to study the impact of transfusions on output and peripheral resis tance. Although peripheral waveforms have been shown to correlate with the fetal hemat ocrit before transfusions [14], one study has found that they were not modified after transfusions [15]. The placental capillary ca pacity may expand rapidly, avoiding over load of the fetal heart and then decrease as fluid is shifted out of the intravascular com partment.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Fetal Blood Volume for Computer-Assisted Management of in utero Transfusion

et al. 1988

View full text Add to dashboard Cite

We performed 41 intravascular ultrasound-guided fetal transfusions in a total of 20 pregnancies with erythroblastosis fetalis or alloimmune thrombocytopenia. On the basis of this experience, we developed a computer-assisted procedure for determining the volume to be transfused, which provides an adequate final concentration. Fetal weight was estimated using ultrasound measurements. Fetoplacental blood volume was estimated from the regression line: fetoplacental volume (ml) = 1.046 + fetal weight (g) × 0.14. The volume to be transfused was calculated using the simple dilution formula:V_transfused = V_{fetoplacental}·(C_final –– C_initial)/C_transfused

show abstract

Section: Discussionmentioning

confidence: 99%

Assessment of Fetal Blood Volume for Computer-Assisted Management of in utero Transfusion

et al. 1988

View full text Add to dashboard Cite

show abstract

“…This publication is designed to update a systematic review of noninvasive methods of determining fetal anaemia initially performed in 2000 1 . The studies reviewed contained data on fetal spleen perimeter, 2 ductus venosus Doppler, 3 thoracic aorta Doppler 4–6 and umbilical vein 7–9 and artery 6 studies. It also contained one study on middle cerebral artery Doppler peak systolic velocity 10 and while other tests have been discarded, middle cerebral artery Doppler has taken over and has replaced amniocentesis as a screening test for fetal anaemia in high risk pregnancies.…”

Section: Introductionmentioning

confidence: 99%

Noninvasive methods of detecting fetal anaemia: a systematic review and meta‐analysis

Pretlove

Fox

Khan

et al. 2009

BJOG

View full text Add to dashboard Cite

Objectives To estimate in a systematic review of the literature the diagnostic value of ultrasound and Doppler blood flow velocity in the evaluation of fetal anaemia.Study selection and data extraction Literature from 2000 to 2008 was identified using MEDLINE and EMBASE, the Cochrane Library and relevant specialist register of the Cochrane Collaboration, and by checking reference lists of known primary studies and review articles. Studies were selected if the accuracy of the fetal ultrasound parameters or Doppler studies of blood flow in the fetal vessels was estimated compared with a reference standard. Data from the selected studies were abstracted as 2 · 2 tables comparing the diagnostic test result with the reference standard. Results were pooled where appropriate. Diagnostic accuracy was expressed as likelihood ratios.Results Twenty-five primary studies were identified containing suitable data on middle cerebral artery Doppler peak systolic velocity (MCA-PSV). The largest group of studies whose data could be pooled containing nine studies gave a positive likelihood ratio of 4.30 (95% CI: 2.50 to 7.41) and a negative likelihood ratio of 0.30 (95% CI: 0.13 to 0.69) for 675 cases in detecting severe anaemia in the analysis.Discussion Although middle cerebral artery peak systolic velocity Doppler has limited diagnostic accuracy, it remains the gold standard for noninvasive screening of fetal anaemia.

show abstract

“…In an attempt to reduce the transfusion frequency, large amounts of blood (relative to the fetoplacental volume) of high viscosity are used [4] . Such intravascular therapy has signifi cant effects upon fetal haemodynamics both in animal models [5] and human pregnancy [6][7][8] . Cord accidents and adverse haemodynamic responses are thought to be the major causes of perinatal loss [3] .…”

Section: Fetal Intravascular Transfusions Via the Intrahepatic Veinmentioning

confidence: 99%

An Audit of Outcome in Intravascular Transfusions Using the Intrahepatic Portion of the Fetal Umbilical Vein Compared to Cordocentesis

Somerset

Moore²,

Whittle³

et al. 2006

Fetal Diagn Ther

View full text Add to dashboard Cite

Introduction: Maternal red cell alloimmunization is a potential cause of perinatal morbidity and mortality. The outcome of severe disease has been transformed by the use of in-utero and particularly, fetal intravascular transfusion. In the majority of instances this is performed by cordocentesis. However, this cohort study represents the experience in a large tertiary referral centre in performing fetal intravascular transfusions via the intrahepatic vein (IHV). Methods: Over an 8-year period, 1997–2004, 221 in-utero transfusions (IUT) were performed for rhesus disease in 66 pregnancies. 86% had severe fetal anaemia caused by anti-D, 10.6% by anti-Kell and 3.4% by anti-c. The median maternal age of the cohort was 31 years (range 19–43). The median gestation at initial IUT was 25 weeks (interquartile range (IQR) 23–29 weeks). Results: A median number of three IUT were performed in each fetus (IQR 2–5) with a median haemoglobin at first fetal blood sampling of 7.3 g% (IQR 4.6–8.8 g%) (73% ≤5 SD and 27% ≤2 SD). Of the total intravascular transfusions, 170 were performed via the IHV (71.7%), 33 via cordocentesis (13.9%) and 1 by intracardiac puncture (0.5%). There were ‘transient’ bradycardias complicating 4.1% of all transfusions and amniorrhexis following 1.4%. 92% of babies were live born at a median gestation of 34 weeks (range 21–38) with a birth weight centile of 50 (range 3–90). There was no significant difference in intravascular transfusion complication rate when the procedure was performed via the IHV (7.6%) as compared to cord root puncture (3.0%) (Fisher’s exact test, p < 0.47). Conclusion: IUT performed by fetal IHV puncture is safe and carries no excess morbidity when performed for severe rhesus disease.

show abstract

Pulsed Doppler flow‐velocity waveforms before and after intrauterine intravascular transfusion for severe erythroblastosis fetalis

Cited by 5 publications

References 0 publications

Assessment of Fetal Blood Volume for Computer-Assisted Management of in utero Transfusion

Assessment of Fetal Blood Volume for Computer-Assisted Management of in utero Transfusion

Noninvasive methods of detecting fetal anaemia: a systematic review and meta‐analysis

An Audit of Outcome in Intravascular Transfusions Using the Intrahepatic Portion of the Fetal Umbilical Vein Compared to Cordocentesis

Contact Info

Product

Resources

About