Perinatal outcomes of intrauterine transfusion for foetal anaemia due to red blood cell alloimmunisation
| Autor: | Ahmet Tayyar, Mehmet Aytac Yuksel, Züat Acar, Ayşe Özge Şavkli, Berna Aslan Çetin, Mustafa Behram, Sema Süzen Çaypınar, Zeynep Gedik Özköse |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Cord Hydrops Fetalis Blood Transfusion Intrauterine Rh Isoimmunization Fetal Distress Ultrasonography Prenatal 03 medical and health sciences 0302 clinical medicine Foetal anaemia Obstetrics and gynaecology Pregnancy Hydrops fetalis medicine Humans Survival rate Retrospective Studies 030219 obstetrics & reproductive medicine business.industry Obstetrics Infant Newborn Foetal Anaemia Obstetrics and Gynecology Gestational age Rh Immunisation medicine.disease Fetal Diseases Red blood cell medicine.anatomical_structure Case-Control Studies 030220 oncology & carcinogenesis Female Intrauterine Foetal Blood Transfusion Anemia Hemolytic Autoimmune business Complication |
| Popis: | The aim of this study was to evaluate the maternal and neonatal outcomes of patients who underwent intrauterine transfusion (IUT) for foetal anaemia due to red blood cell alloimmunisation and to determine the factors that affected the outcomes. All pregnancies that were treated with IUT due to Rh immunisation between January 2015 and June 2018 in the Kanuni Sultan Suleyman Training and Research Hospital, Department of Obstetrics and Gynaecology, were evaluated retrospectively. IUT due to non-Rh alloimmunisation, parvovirus B19 infection, chronic fetomaternal haemorrhage and foetal anaemia due to homozygous alpha-thalassemia were not included in the study. The perinatal and neonatal outcomes of the patients were retrospectively analysed. The gestational age, ultrasonography findings before and after IUT, laboratory results, complications related to IUT, and data on the newborns were recorded. The cases were divided into two groups, those with complication and those without complications, and their perinatal outcomes were compared. A total of 110 IUTs were performed in 42 foetuses. The survival rate after transfusion was 80.95%. Procedure-related complications were found in 12.7% of cases. There were no significant differences between the demographic and clinical characteristics of the patients with and without complications. The survival rate was lower and perinatal mortality was higher in foetuses with hydrops fetalis. IUT is a safe and effective procedure that can be used in the treatment of foetal anaemia in experienced centres. Survival rates can be increased by referring patients to experienced perinatology centres, by improving the IUT technique, and by reducing technique-related complications.Impact statementWhat is already known on this subject? The predominant use of IUT is to treat foetal anaemia due to red blood cell alloimmunisation. Despite the decrease after anti-D immune globulin prophylaxis, Rh immunisation is still a major cause of foetal anaemia. However, foetal survival rates have increased with the use of IUT.What do the results of this study add? The survival rates were increased after the development of a high-resolution ultrasound. Because foetal monitoring can be performed by ultrasonography, cord accidents and overload findings can be detected during transfusion, which allows for early interventions and increases survival rates.What are the implications of these findings for clinical practice and/or further research? The IUT procedure can be used in the treatment of foetal anaemia in experienced centres. After the technique was improved, the complication rates related to the procedure were decreased and foetal survival rates were increased. Further studies on the use of different IUT techniques will extend our findings. |
| Databáze: | OpenAIRE |
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