Iranian Journal of Neonatology

Iranian Journal of Neonatology

Short Neonatal Outcomes after Intrauterine Transfusion in Fetal Anemia, the Experience from a Referral Academic Center

Document Type : Original Article

Authors
Mahboobeh Shirazi 1
Elham Feizabad 2
Ghazaleh Bahmanpour 1
Marjan Ghaemi 3
Fatemeh Takaloo 4
Mahmoud Shirazi 5
Alireza Omidi Farzin 6
Azadeh Heidarpour 1
1 Yas Hospital Complex, Maternal Fetal and Neonatal Research Center,Tehran University of Medical Sciences, Tehran, Iran
2 Community medicine specialist, Yas Hospital Complex Department of obstetrics and gynecology, Tehran University of Medical Sciences, Tehran, Iran
3 Vali-E-Asr Reproductive Health Research Center, Family Health Research Institute, Tehran University of Medical Sciences, Tehran, Iran
4 Hamedan University of Medical Sciences, Hamedan, Iran
5 Department of Psychology, Faculty of educational and psychology, University of Sistan and Baluchestan, Zahedan, Iran
6 Shahid Modarres Hospital, Department of Cardiovascular Surgery,Shahid Beheshti University of Medical Sciences, Tehran,Iran
10.22038/ijn.2022.63924.2225
Abstract
Background: Rhesus D-antibodies and maternal red blood cell alloimmunizations are the major causes of fetal anemia, which can cause hydrops and perinatal death if not treated through intrauterine intravascular blood transfusion (IUT). This paper sought to report the short-term neonatal outcomes after IUT in a referral academic center.
Methods: The population of this retrospective cohort study comprised all pregnancies that underwent IUT between March 2014 and March 2019. The maternal obstetrics characteristics as well as blood group, antibody screen, and titers were reported. Indeed, the fetal and neonatal outcomes and complications were described either.
Results: A total of 141 IUTs were performed in 58 women. Of all, 15 fetuses were hydropic at the first transfusion. The mean±SD (standard deviation) of gestational age and hemoglobin at the first transfusion was 27.06±4.25 weeks and 6.62±2.91 g/dL, respectively. The range of transfusions was 1.8 per woman and the mean±SD amount of blood transfusion in IUT was 84.03±48.79 cc. 7/58 (12%) intrauterine and 6/58 (10%) neonatal death were reported, of which, four cases were hydropic and the others suffered from severe anemia. The mean±SD of gestation age at delivery was 33.6 ± 3.33 weeks. A significant difference was observed between mean fetal hemoglobin levels before and after performing the IUT procedure (p< 0.01). Also, middle cerebral artery (MCA) Doppler assessments showed anemia severity decreased following IUT
Conclusion: It seems Intrauterine transfusion is a lifesaving procedure that can boost perinatal survival in fetuses with anemia.
 
 
Keywords
Anemia
Hydrops fetalis
Intrauterine blood transfusion
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Iranian Journal of Neonatology
Volume 13, Issue 4
Autumn 2022
Pages 28-33