Intrauterine Transfusions: New Techniques and Results

Larkin, R. M.; Knochel, John Q.; Lee, Timothy G.

doi:10.1097/00003081-198206000-00010

Cited by 18 publications

(8 citation statements)

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“…In recently published studies an increase in perinatal survival up to 92% has been reported [56,57,69,70,72,78], Mortality rates in hydrop ic infants range between 25 and 66% [43,57,72,73], The incidence of traumatic death as the major source of mor tality, has decreased since the use of real time ultrasound guidance. Fetal mortality within 48 h of the procedure is considered as a direct result of the intrauterine transfu sion.…”

Section: Resultsmentioning

confidence: 99%

“…Fetal mortality within 48 h of the procedure is considered as a direct result of the intrauterine transfu sion. In recent series initial mortality rates of 2.3-9.3% have been reported [57,69,70,72,73]. The direct fetal risk per procedure is estimated at 2-3% [57,73,79].…”

Section: Resultsmentioning

confidence: 99%

“…Mater nal morbidity after intraperitoneal transfusion occurs in 1-2% of the reported cases. Infection, hepatitis and pla cental abruption have been reported [43,72,80].…”

Section: Resultsmentioning

confidence: 99%

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Management of Serious Alloimmunization in Pregnancy

Gravenhorst¹

1988

Vox Sanguinis

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In the past 40 years, tremendous advances in the treatment of hemolytic disease have been made. The perinatal mortality has been reduced considerably. Rh immunoprophylaxis has decreased the incidence of Rh immunization to around 6 per 100,000 live births. Nevertheless, treatment of severe hemolytic disease is still essential. Increased reliability of diagnostic procedures have made early detection and optimal treatment of hemolytic disease possible. Treatment by plasmapheresis is still controversial. Although believed to be beneficial by some authors, conclusive evidence of its efficacy has not been obtained. With preterm induction of birth at 32 weeks of gestation, the chances for survival are 95%. Improvement of techniques and the use of modern real-time ultrasound equipment have made intrauterine intraperitoneal transfusion, in experienced hands, a relatively safe and successful procedure. Intravascular transfusion appears beneficial in early pregnancy. Combination of both techniques will probably be the answer for the future. The development of neonatal intensive care facilities has made a major contribution to the survival of children with haemolytic disease. The relative low incidence of haemolytic disease has made it imperative that treatment should take place in centers where experience and special skill are available.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Management of Serious Alloimmunization in Pregnancy

Gravenhorst¹

1988

Vox Sanguinis

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“…Refinements in technique and especially the use of modern ultrasound equipment have facilitated the procedure and improved the results [44,45,46,47,48].In its original design intrauterine transfusion was based on the fact that red cells can be absorbed from the fetal peritoneal cavity and enter the fetal circulation [49,50]. By infusing Rhesus (D) negative packed cells into the foetal abdomen, foetal anaemia can be corrected and delivery may be postponed to a more advanced stage in pregnancy.…”

Section: Therapymentioning

confidence: 99%

Diagnosis and treatment of severe alloimmunization

Gravenhorst¹

1994

Vox Sanguinis

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“…Recently, real-time ultrasound has played a major role in performing intrauterine transfusion for severely affected fetuses. 3 After the intrauterine transfusion, ultrasound is also useful to follow the clinical course of the fetus.· A consideration in the management of these patients is the time course for absorption of the transfused blood. Since ultrasound is capable of identifying transfused blood in the fetal peritoneal cavity, we reviewed our experience with ultra 7 sound-guided intrauterine transfusions to determine the normal time course for disappearance of the intraperitoneal blood.…”

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Absorption of fetal intraperitoneal blood after intrauterine transfusion.

Hashimoto¹,

Filly²,

Parer³

1987

Journal of Ultrasound in Medicine

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We reviewed the sonograms and medical records of all patients who underwent intrauterine transfusions between December 1981 and December 1984 in order to determine the time course for disappearance of the intraperitoneal blood. Seventy-two sonographic examinations were performed on 22 patients who underwent 51 intrauterine transfusions. Nonhydropic fetuses who received s 50 cc of intraperitoneal blood exhibited no ul· trasonic evidence of intraperitoneal fluid after 8 days.U ltrasonography has become an integral part of the management of Rh isoimmunized fetuses.1.2 The severity of disease and possible progression toward the hydropic state may be followed using ultrasound evaluation. Recently, real-time ultrasound has played a major role in performing intrauterine transfusion for severely affected fetuses. 3 After the intrauterine transfusion, ultrasound is also useful to follow the clinical course of the fetus.· A consideration in the management of these patients is the time course for absorption of the transfused blood. Since ultrasound is capable of identifying transfused blood in the fetal peritoneal cavity, we reviewed our experience with ultra 7 sound-guided intrauterine transfusions to determine the normal time course for disappearance of the intraperitoneal blood. MATERIAL AND METHODSWe reviewed the medical charts and ultrasound examinations of all patients who had intrauterine transfusions at our institution between December 1981 and December 1984. Ultrasound examinations were performed on commercially available real-time equipment.Twenty-two patients underwent 51 intrauterine transfusions during this time period. The decision to perform an intrauterine transfusion was based upon the optical density at 450 u (600450) of the patient's amniotic fluid. Patients with 600450 rising to zone III of the Liley graph were candidates for intrauterine transfusion. 2 Hydropic fetuses were not excluded. Seven fetuses had hydrops with ascites.The fetuses who had intrauterine transfusions ranged from 18 to 32 menstrual weeks. The volume of packed red blood cells injected at each intrauterine transfusion was based upon fetal age. l If {etal ascites was present prior to an intrauterine transfusion, as much of the peritoneal fluid as possible was aspirated before the packed red blood cells were injected.The fetal abdomen was observed using real~time ultrasound during all intrauterine transfusions. Intraperitoneal packed red blood cells initially may appear echo-

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Intrauterine Transfusions: New Techniques and Results

Cited by 18 publications

References 0 publications

Management of Serious Alloimmunization in Pregnancy

Management of Serious Alloimmunization in Pregnancy

Diagnosis and treatment of severe alloimmunization

Absorption of fetal intraperitoneal blood after intrauterine transfusion.

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