Complications of intravascular intrauterine transfusion for Rh alloimmunization.

Autor:	Alkhaibary A; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Ali M; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Tulbah M; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Al-Nemer M; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Khan RM; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Al Mugbel M; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Al Sahan N; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia., Hassounah MM; From the Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia., Alshammari W; From the Department of Family and Community Medicine, King Saud University, Riyadh, Saudi Arabia., Kurdi WI; From the Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Annals of Saudi medicine [Ann Saudi Med] 2021 Nov-Dec; Vol. 41 (6), pp. 313-317. Date of Electronic Publication: 2021 Dec 02.
DOI:	10.5144/0256-4947.2021.313
Abstrakt:	Background: Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities. Objective: Review the outcomes of Rh alloimmunization, including indications and possible complications. Design: Retrospective cohort (medical record review). Setting: Tertiary care center. Patients and Methods: We retrieved the records for all mothers who had an IUT for Rh alloimmunization between January 2009 and August 2019. We collected data on complications, post-transfusion hemoglobin and antibody combinations. Main Outcome Measure: Complications of IUT. Sample Size: 119 mothers with 154 fetuses (154 different pregnancies). Results: The 154 fetuses had 560 intrauterine transfusions. The median pre-IUT hemoglobin was a median of 8.0 g/dL while the median post-IUT hemoglobin 16 g/dL. Immediate procedure-related complications included fetal bradycardia in 2.7%, significant bleeding from the cord puncture site (for more than 2 minutes in 0.9%), and contractions in 0.9%. Eight (5.2%) were delivered by cesarean delivery due to IUT-specific complications such as post-procedure fetal bradycardia. Intrauterine fetal death complicated 8.4% of the pregnancies (13 fetuses). Phototherapy was required in 76 (49.4%), postnatal blood transfusions in 17 (11%), and exchange transfusion in 11 (7.1%). Neonatal death occurred 8 (5.2%). Data were insufficient to assess associations of complications with antibody combinations. Conclusions: Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization). Limitations: Case series. Conflict of Interest: None.
Databáze:	MEDLINE
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