Fetal Intrauterine Transfusion

2017 ◽  
Vol 1 (1) ◽  
pp. 27-29
Author(s):  
Amitha Indersen
Keyword(s):  
Treatment Strategy ◽  
Peak Systolic Velocity ◽  
Noninvasive Monitoring ◽  
Comprehensive Treatment ◽  
Blood Transfusions ◽  
Fetal Anemia ◽  
Fetal Blood ◽  
Monitoring And Diagnosis ◽  
Intrauterine Transfusion ◽  
Treatable Condition

ABSTRACT Fetal anemia is a recognizable and treatable condition. It requires identification of the etiology to plan a comprehensive treatment strategy. Fetal blood transfusions help tide over crisis and avert fetal cardiovascular decompensation or deterioration due to the anemia. Based on the cause and the fetal condition, the timing and requirement for transfusion are determined. At present, noninvasive monitoring with fetal middle cerebral arterial Doppler peak systolic velocity is the standard for monitoring and diagnosis of fetal anemia. How to cite this article Indersen A. Fetal Intrauterine Transfusion. World J Anemia 2017;1(1):27-29.

Middle Cerebral Artery Doppler Changes following Fetal Transfusion Performed with and without Fetal Anesthesia

2017 ◽  
Vol 35 (07) ◽  
pp. 682-687 ◽  
Author(s):  
Kristen Uquillas ◽  
Myrna Aboudiab ◽  
Lisa Korst ◽  
Arlyn Llanes ◽  
Brendan Grubbs ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Umbilical Cord ◽  
Cerebral Artery ◽  
Gestational Age ◽  
Peak Systolic Velocity ◽  
Fetal Anemia ◽  
Intravenous Anesthesia ◽  
Intrauterine Transfusion ◽  
The Difference ◽  
The Relationship

Objective The objective of this study was to test the association between fetal intravenous anesthesia and the change in middle cerebral artery peak systolic velocity (MCA-PSV) in patients undergoing intrauterine transfusion (IUT) for suspected fetal anemia. Study Design We retrospectively examined data from all patients who underwent IUT via umbilical cord route from 2007 to 2016. We calculated the change of the MCA-PSV multiple of median (MoM) as the difference in MCA-PSV MoM between the pre- and immediate postoperative measurements for the first IUT. The change in MCA-PSV MoM was compared between those who did and did not receive fetal anesthesia using Kruskal–Wallis' testing. Results Of 62 patients, 37 (59.7%) received intravenous fetal anesthesia and 25 (40.3%) did not. The change in MCA-PSV MoM did not differ between those who did and did not receive fetal anesthesia (median: 0.57 [interquartile range, IQR: +0.42 to +0.76] vs. median 0.57 [IQR: +0.40 to +0.81], p = 1.000). The relationship remained insignificant when stratifying by gestational age, length of procedure, initial MCA-PSV, and when excluding hydropic fetuses. Conclusion Among women undergoing IUT, there was no evidence that the use of fetal anesthesia was associated with a change in the pre- versus postoperative change in MCA-PSV MoM.

scholarly journals Successful Management of the Fetal Severe Anemia Associated with Jra Alloimmunization by Intrauterine Transfusion of Jr(a+) Red Blood Cells

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Masatake Toshimitsu ◽  
Shinichi Nagaoka ◽  
Shuusaku Kobori ◽  
Yuichiro Takahashi ◽  
Jun Murotsuki
Keyword(s):  
Red Blood Cells ◽  
Blood Cells ◽  
Case Reports ◽  
Peak Systolic Velocity ◽  
Late Gestation ◽  
Fetal Anemia ◽  
Severe Anemia ◽  
Doppler Measurement ◽  
Emergency Situations ◽  
Intrauterine Transfusion

Objective. We present a case of fetal severe anemia associated with Jra alloimmunization, which was managed using Doppler measurement of the peak systolic velocity of the fetal middle cerebral artery (MCA-PSV) and intrauterine transfusion (IUT) of Jr(a+) red blood cells (RBCs). We also review the previous case reports on fetal or neonatal anemia associated with Jra alloimmunization. Case Report. A woman with Jra alloimmunization was referred to our department at 29 weeks of gestation. As fetal MCA-PSV exceeded 1.55 multiples of the median, fetal blood sampling was performed and demonstrated severe anemia. During the course, a total of two IUTs were performed using Jr(a+) RBCs. The neonate was delivered by repeated cesarean section at 35 weeks of gestation and showed no apparent signs of hemolysis. Conclusion. Based on the literature review, fetal anemia associated with Jra alloimmunization becomes severe during mid-gestation and may not develop during late gestation. The severity of fetal anemia is predicted by MCA-PSV Doppler assessment rather than the maternal anti-Jra titers. Timely IUT of Jr(a+) RBCs can help to prolong the pregnancy to term in emergency situations wherein compatible blood of Jr(a-) RBCs is not available soon.

scholarly journals Severe fetal anemia and hydrops fetalis associated with compound heterozygosity for Hb Zurich-Albisrieden (HBA2:c.178G>C) and Hb Quong Sze (HBA2:c.377T>C)

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110314
Author(s):  
Li Du ◽  
Xiuqin Bao ◽  
Wei He ◽  
Danqing Qin ◽  
Jicheng Wang ◽  
...  
Keyword(s):  
Chinese Population ◽  
Peak Systolic Velocity ◽  
Compound Heterozygote ◽  
Blood Transfusions ◽  
Fetal Anemia ◽  
Compound Heterozygosity ◽  
Third Trimester ◽  
Fetal Autopsy ◽  
The Third ◽  
Hb Bart's

We report on a fetus with cardiomegaly and increased middle cerebral artery-peak systolic velocity at 25 weeks of gestation. Severe fetal anemia (hemoglobin (Hb) level 37 g/L) was confirmed by cordocentesis. Hb analysis showed that Hb Bart’s was 9% in cord blood. Molecular analysis of the proband’s family found that the mother was a carrier of Hb Quong Sze (Hb QS, HBA2:c.377T>C), the father was a carrier of Hb Zurich-Albisrieden (Hb ZA, HBA2:c.178G>C), and the fetus was a compound heterozygote for Hb ZA and Hb QA. Despite intrauterine blood transfusions, the fetus experienced problems including oligohydramnios, growth retardation, placental thickening, and heart enlargement in the third trimester. The couple chose to terminate the pregnancy, and fetal autopsy confirmed the above diagnosis. This is the first report of a case of Hb ZA compounded with Hb QS, and provides a reference for genetic counselling and prenatal diagnosis in the Chinese population.

Modern methods of treatment of intrauterinenon-immune fetal hydropsinduced by parvovirus infection

2020 ◽  
pp. 43-47
Author(s):  
N.P. Bondarenko ◽  
◽  
V.P. Lakatosh ◽  
Ya.M. Vitovsky ◽  
T.T. Narytnyk ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pregnant Women ◽  
Parvovirus B19 ◽  
Peak Systolic Velocity ◽  
Terminal Condition ◽  
Fetal Anemia ◽  
Second Trimester ◽  
Gestation Age ◽  
Intrauterine Transfusion ◽  
Lethal Rate

During ultrasonography examinationfetuses infected by parvovirus B19, we have established 36/129 (27.9%) cases of non-immune hydrops in the different periods of pregnancy.The hyperdynamic type of blood flow in fetal middle cerebral arterial was observed in fetuses at the second trimester. Measurement of fetal middle cerebral arteria peak systolic velocity was started at 18 weeks of gestationonce a week in pregnant women who were infected by parvovirus B19. During our study were found 17 cases of severe fetal anemia which manifested after 18 weeks of gestation.Intrauterine transfusions were performed for 11 pregnant women with parvovirus induced fetal hydrops whose gestation age were between 22.4 -25.7 (average 24.0±0.2). After cordocentesis11 cases of severe fetal anemia were confirmed.In the last 6 cases fetuses were diagnosed terminal condition due to women`s refusal of intrauterine transfusion or untimely admission to the hospital. Taking to account the results of study, the efficacy of treatment non-immune hydrops infected by parvovirus B19 with severe fetal anemia and outcomes were evaluated and analyzed. Successful treatment of parvovirus-induced fetal non-immune hydrops in the second trimester of pregnancy has been found in 72.7% cases (OR=95%) after intrauterine transfusion compared to 100% lethal rate in fetuses with non-immune hydrops and severe anemia who were not treated. Criteria for effectiveness of intrauterine transfusion are in time diagnosis of severe fetal anemia in infected fetus with non-immune hydrops, determine the optimal gestation age for intrauterine transfusion, indicators of viremia in umbilical cord blood, the compensatory capacity of the fetus based on Doppler metric indicator of middle cerebral arterial peak systolic velocity and changes blood flow in ductus venous of the fetus. It helps to reduce perinatal loss. Keywords: parvovirus infection, non-immune hydrops fetalis, intrauterine transfusion.

Early procedure‐related complications of fetal blood sampling and intrauterine transfusion for fetal anemia

2012 ◽  
Vol 91 (4) ◽  
pp. 458-462 ◽  
Author(s):  
CARINA JOHNSTONE‐AYLIFFE ◽  
TOMAS PRIOR ◽  
CHARAS ONG ◽  
FIONA REGAN ◽  
SAILESH KUMAR
Keyword(s):  
Blood Sampling ◽  
Fetal Anemia ◽  
Fetal Blood ◽  
Fetal Blood Sampling ◽  
Intrauterine Transfusion

scholarly journals Intrauterine Transfusions in FHD: When and How?

2013 ◽  
Vol 7 (4) ◽  
pp. 481-483
Author(s):  
Miroslaw Wielgos ◽  
Robert Brawura-Biskupski-Samaha
Keyword(s):  
Gold Standard ◽  
Obstet Gynecol ◽  
Peak Systolic Velocity ◽  
Fetal Hemoglobin ◽  
Hemoglobin Level ◽  
Blood Transfusions ◽  
Fetal Blood ◽  
Hemolytic Disease ◽  
A Value ◽  
Moderate Anemia

ABSTRACT Intrauterine fetal blood transfusions still remain the gold standard of prenatal therapy in severe cases of fetal hemolytic disease due to mother-fetus immunization. Middle cerebral artery-peak systolic velocity (MCA-PSV) measurements plays the most important role in diagnosing the disease. A value of MCA-PSV >1.5 allows us to diagnose severe or moderate anemia and prompts us to treat the patient. The time of subsequent transfusions is estimated by the hemoglobin level directly after the transfusion and the fact that the concentration of fetal hemoglobin in blood decreases at a rate of 0.3 g% per day. Even though effective, these procedures carry with them major risks and that is why prophylaxis is essential. How to cite this article Wielgos M, Brawura-Biskupski- Samaha R. Intrauterine Transfusions in FHD: When and How? Donald School J Ultrasound Obstet Gynecol 2013;7(4):481-483.

scholarly journals Fetal Blood Transfusion: The Saviour

2018 ◽  
Vol 54 (01) ◽  
pp. 011-032
Author(s):  
Devendra Arora
Keyword(s):  
Blood Transfusion ◽  
Doppler Ultrasound ◽  
Gestational Age ◽  
Neonatal Outcome ◽  
Neonatal Period ◽  
Tertiary Care ◽  
Peak Systolic Velocity ◽  
Intrauterine Fetal Death ◽  
Fetal Anemia ◽  
Fetal Blood

AbstractThe purpose of this oration is to discuss the modality of highly specialized Intra vascular fetal blood transfusion and its various sites to perform fetal blood transfusion with the role of middle cerebral artery-peak systolic velocity (MCA-PSV), as measured by Doppler ultrasound, in managing fetal anemia in Rh-alloimmunized pregnancies. Intra-uterine fetal blood transfusion was performed in such anemic fetuses to tide over the crisis of fetal immaturity till considered fit for extra-uterine survival. Rh-alloimmunized pregnancies with or without hydrops reporting to our tertiary care institute from January, 2005 to December, 2015 were screened by Doppler ultrasound to estimate MCA-PSV to detect fetal anemia. During follow-up, if the fetus developed MCA-PSV values more than 1.5 MoM for the gestational age, fetal blood sampling through cordocentesis was performed to confirm fetal anemia. This was followed by intra-uterine fetal blood transfusion to all the anemic fetuses at the same sitting. The neonatal outcome was evaluated by recording gestational age at the time of delivery, duration of gestational time gained, and need for blood transfusion in the neonatal period. A total of 226 Rh-alloimmunized pregnancies were evaluated. Three hundred ninety six intra-uterine fetal blood transfusions were performed. In their neonatal period, 137 neonates received blood transfusion. Intrauterine fetal death occurred in 11 fetuses out of which 7 were grossly hydropic fetus. Favorable neonatal outcome was recorded in the rest including 42 hydropic fetuses. The clinical outcome of these pregnancies justifies the use of Doppler studies of MCA-PSV in detecting fetal anemia as these were found to correlate well. Intra-uterine fetal blood transfusion in the anemic fetuses is the only hope of prolonging pregnancy salvaging such fetuses.

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