Our experience with multiple intrauterine fetal blood transfusions for severe hemolytic disease due to rhesus incompatibility


Дәйексөз келтіру

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Аннотация

Objective: To investigate the feasibility and efficacy of multiple intrauterine blood transfusions (IUT) in severe Rh hemolytic disease of the fetus and newborn (HDFN). Materials and methods: The study comprised 99 pregnant women with Rh alloimmunization, including 4 (4%) patients with severe HDFN (group I), 74 (74.7%) with very severe HDFN (group II), and 21 (21.2%) with hydrops fetalis (group III). All patients received multiple (from 3 to 7) IUTs. Exchange transfusions were performed in 65 (68.4%) neonates on the 1st day of life, and 17 (17.9%) received regular blood transfusions on days 3-5. The perinatal outcomes were evaluated. Results: Multiple IUTs for severe HDFN in 72.7% of patients resulted in prolonging gestation to 32-36 weeks, 96% fetal survival, including 80.9% for hydrops fetalis. A hematocrit level <25th percentile indicates the adverse course of severe HDFN. Earlier intrauterine treatment for hydrops fetalis (at 19-23 weeks) and 4 to 6 IUTs performed resulted in fewer exchange transfusions (72.7%) and regular transfusions (18.2%) compared with intrauterine treatment started later (at 24-27weeks) and only 3 IUTs performed (87.5% and 37.5%, respectively). Conclusion: IUT is the best available treatment for HDFN, allowing for improved perinatal outcomes in severe disease.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Galina Savelyeva

Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation

Dr. Med. Sci., Academician of the RAS, Professor at the Department of Obstetrics and Gynecology of Pediatric Faculty

Alexander Konoplyannikov

Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation

Email: npo.med@gmail.com
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynecology of Pediatric Faculty

Elena Karaganova

Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation

Email: karaganova22@gmail.com
MD, PhD, Associate Professor at the Department of Obstetrics and Gynecology of Pediatric Faculty

Aleksandra Smirnova

Center for Family Planning and Reproduction, Moscow Healthcare Department

MD, Head of the Consulting and Diagnostic Department

Maria Astrakhantseva

Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation

Email: agpf.gms@gmail.com
MD, Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology of Pediatric Faculty

Natalia Martynova

Lomonosov Moscow State University

Email: martynovanatalia96@yandex.ru
Clinical Resident at the Department of Obstetrics and Gynecology, Faculty of Fundamental Medicine

Oleg Latyshkevich

Pirogov Russian National Research Medical University, Ministry of Health of the Russian Federation; Center for Family Planning and Reproduction, Moscow Healthcare Department

Email: latishkevich@mail.ru
MD, Ph.D., Teaching Assistant at the Department of Obstetrics and Gynecology of Pediatric Faculty

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