Fetoplacental Blood Volume Estimation in Pregnancies with Rh Alloimmunization

Leduc, Line; Moise, Kenneth J.; Carpenter, Robert J.; Cano, Lorraine E.

doi:10.1159/000263583

Cited by 40 publications

(27 citation statements)

References 15 publications

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“…In addition, the fetoplacental volume frequently needs to be estimated prior to determining the appropriate transfusion volume. Previously, other investigators have published methods used to determine the fetoplacental blood volume [11][12][13]. Such complex mathematical formulas do not lend themselves readily to bedside calculation.…”

Section: Discussionmentioning

confidence: 99%

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A Simple Method to Estimate Volume for Fetal Intravascular Transfusions

1998

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We derived a constant termed the transfusion coefficient to simplify the estimation of the fetal intravascular transfusion volume. The product of the estimated fetal weight (g) and 0.02 (transfusion coefficient), estimates the transfusion volume (ml) required to increase the fetal hematocrit by approximately 10 percentage points. Our estimation was comparable to Mandelbrot’s technique and better than Plecas’ method for estimating fetal transfusion volumes. Utilizing the transfusion coefficient to estimate the intravascular transfusion volume for an anemic fetus is simple, rapid and accurate.

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Section: Discussionmentioning

confidence: 99%

“…Since the estimation of fetoplacental blood volume, an integral component in the determination of the transfusion volume, is dependent upon fetal weight [11][12][13], we took advantage of this relationship in establishing our method.…”

Section: Discussionmentioning

confidence: 99%

A Simple Method to Estimate Volume for Fetal Intravascular Transfusions

1998

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“…Most methods used the increase in hematocrit during an intrauterine transfusion to calculate the initial total blood volume. However, these methods either overestimated the blood volume by assuming that the final blood volume equals the initial blood volume [12] , or they underestimated the blood volume by assuming that the final blood volume equals the sum of the initial blood volume with the added donor blood volume [13][14][15][16] . In animal experiments, both assumptions were shown to be incorrect, as around 30% of the volume given during transfusion immediately leaves the circulation [17] .…”

Section: Introductionmentioning

confidence: 99%

Total Blood Volume Is Maintained in Nonhydropic Fetuses with Severe Hemolytic Anemia

Pasman¹,

Brink²,

Kamping³

et al. 2009

Fetal Diagn Ther

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Objective: Fetal alloimmune anemia is associated with increased blood flow velocities and cardiomegaly. In severe cases, hydrops can develop. We investigated whether the decrease of red blood cell volume is associated with a reduction or expansion of plasma volume. Methods: In 86 alloimmunized fetuses that received a first intrauterine transfusion, we calculated fetal total blood volumes (i.e. fetoplacental blood volumes) using a dilutional principle of fetal hemoglobin with adult hemoglobin. The relation between total blood volume and estimated fetal weight, severity of anemia and hydrops was analyzed. Results: Gestational age ranged from 17 to 35 weeks. Mean hemoglobin deficit was 6.8 standard deviations (range 2.1–11.7) below the normal mean. Fetal total blood volume was significantly related to estimated fetal weight (p < 0.001). Mean total blood volume in nonhydropic fetuses was 123 ml/kg (n = 74) and in hydropic fetuses 144 ml/kg (n = 12). There was a significant relation between total blood volume per kg body weight and hydrops (p = 0.035); however, there was no relation with severity of anemia (p = 0.94). Conclusion: In the human nonhydropic fetus with severe hemolytic anemia, total blood volume is maintained: the decrease in red blood cell volume is thus compensated by an increase in plasma volume. In hydropic fetuses, however, total blood volume seems to be increased. This is in accordance with the hypothesis that congestive heart failure plays a role in the pathophysiology of hydrops in anemic fetuses.

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“…If the same phenomenon occurs in the human fetus, the post-transfusion Ht becomes an unstable value. Consequently, the calculation of the FPV by using the post-transfusion Ht within a changing total blood volume leads to an incorrect and under-estimated feto-placental blood volume 5 . In infants needing blood transfusion, both post-as well as the pre-transfusion Ht values may be unreliable because of fluctuations in the intravascular plasma volume 6,7 .…”

Section: Introductionmentioning

confidence: 99%