Long-term neurodevelopmental outcome after intrauterine transfusion for the treatment of fetal hemolytic disease

Hudon, Lynda; Moise, Kenneth J.; Hegemier, Suzanne; Hill, Reba M.; Moïse, Alicia A.; Smith, E. O’Brian; Carpenter, Robert J.

doi:10.1016/s0002-9378(98)70178-4

Cited by 110 publications

(58 citation statements)

References 11 publications

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“…In the two cases reported by Ghi et al, as well as in ours, the cerebellar abnormalities were seen only after the first transfusion. In contrast to previous studies, which did not show an increased risk of brain damage in infants who underwent intravascular transfusions 26,27 , these data indicate that brain injury may occur prenatally in fetuses with early extreme anemia. Ghi et al have speculated that the hyperdynamic circulation caused by fetal anemia, in addition to hypoxia/ischemia, might damage the brain vessels 25 , yet the pathophysiology leading to cerebellar abnormalities in these fetuses is still unclear.…”

Section: Discussioncontrasting

confidence: 99%

“…The baseline characteristics of these women are summarized in Table 1. Ten women were noted to have had at least one previous stillbirth as a result of alloimmunization at a median gestational age of 24 weeks (range, [19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. Of this cohort, 26 (87%) were associated with anti-D, four (13%) with anti-Kell and 12 had more than one antibody type involved.…”

Section: Resultsmentioning

confidence: 99%

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Early intrauterine transfusion in severe red blood cell alloimmunization

Yinon

Visser

Kelly

et al. 2010

Ultrasound in Obstet & Gyne

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Objective To determine perinatal outcome in pregnancies with early severe red blood cell (RBC) IUT was 20.4 (range,[16][17][18][19][20][21][22] weeks, and between one and nine transfusions were needed during pregnancy. Transfusion was via the intrahepatic vein (IHV) (n = 19), umbilical vein (n = 6) or umbilical artery (n = 2), or was intracardiac (n = 2) or intraperitoneal (n = 1). Overall perinatal survival rate was 80% and did not differ between hydropic and non-hydropic fetuses. Median gestation at delivery, after exclusion of six intrauterine fetal deaths, was 36.7 (range, 27.8-38.4)

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Section: Discussioncontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Early intrauterine transfusion in severe red blood cell alloimmunization

Yinon

Visser

Kelly

et al. 2010

Ultrasound in Obstet & Gyne

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“…Regarding the long-term consequences of fetal anemia, cerebral palsy and developmental delay are more common in fetuses with HDFN when compared with unaffected fetuses, but in more than 90 % of cases, the psychomotor development is normal [35] . Normal developmental outcome during standardized developmental assessments in the fi rst 62 months was observed for children treated with IUTs for severe fetal hemolytic disease [32] . In a study of 16 hydropic patients who were evaluated at a mean age of 10 years, the incidence of severe neurologic morbidity was estimated to be 12.5 % [31] .…”

Section: Complications and Short-or Long-term Outcomementioning

confidence: 99%

Therapeutic management of fetal anemia: review of standard practice and alternative treatment options

Παπαντωνίου

Sifakis

Antsaklis

2012

Journal of Perinatal Medicine

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Fetal anemia, mainly due to red cell alloimmunization, is still a signifi cant cause of fetal and neonatal mortality and morbidity. The focus of current clinical research has shifted from an invasive approach to non-invasive management and treatment of affected pregnancies, and the progress in this fi eld is associated with a major improvement in perinatal outcome. During the last 50 years, intrauterine red cells transfusion (IUT), fi rst via the intraperitoneal route and later directly to fetal circulation, is the standard practice in most centers, with survival rates that exceed 90 % , particularly if anemia is diagnosed early and treated in a timely manner. In addition, plasmapheresis and intravenous administration of highdose immunoglobulin have been implicated in the treatment of pregnancies complicated with early-onset severe red cell alloimmunization, alone or in combination with IUTs before the 20 th week of pregnancy, but there are still issues to be clarifi ed further. This review article aims to provide an overview of the current standard therapeutic management and alternative treatment modalities in pregnancies complicated by fetal anemia.

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“…Neuroimaging (MRI or CT) was performed in six cases and showed evidence of demyelination. The consequences of anemia secondary to parvovirus B19 can be comparable to neonates with blood group incompatibility where adverse neurodevelopmental outcome have been reported to be in the range of 4.5% to 10% [49][50][51]. Therefore, one may speculate that the a combination of each of the above pathophysiological mechanisms may be implicated in the occurrence of adverse neurodevelopmental outcome.…”

Section: Discussionmentioning

confidence: 99%

Parvovirus B19 Infection in Pregnancy: Implications for Childhood Outcomes?

Jain¹,

Kelly²,

Shah³

2009

TOIDJ

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Abstract:Background: Maternal parvovirus B19 infection can lead to serious consequences in the fetus including fetal death, non-immune hydrops fetalis and possibly long-term adverse neurodevelopmental outcome. To date, there has been no systematic review of the literature regarding long-term outcomes of these infants and children.Objective: To systematically review the literature on the long-term neurodevelopmental outcomes of infants and children born to mothers with acute parvovirus B19 infection in pregnancy.Methods: Electronic databases MEDLINE, EMBASE, CINAHL, PsychInfo, Cochrane Database of Systematic Reviews (CDSR) and Cochrane Central Register of Controlled Trials (CCRT) were searched to identify studies that reported on long-term neurodevelopmental outcome of infants and children born following maternal parvovirus B19 infection in pregnancy. No language restrictions were applied. Data synthesis was performed using qualitative description and was categorized based on 1) outcome of infants and children with clinical presentation of non-immune hydrops fetalis and 2) outcomes of infants and children born to mothers with serologic evidence of acute infection.Results: Eleven studies were included. Five studies reported on outcomes in infants and children with non-immune hydrops fetalis while six studies reported on outcomes in infants and children born to mothers with serologic evidence of acute infection. There is a suggestion that the incidence of adverse neurodevelopmental outcome is higher in those who present with non-immune hydrops fetalis [18% (7/39), range from individual studies 0-31.3%] compared to asymptomatic infants and children born to mothers with acute parvovirus B19 infection in pregnancy [2.4% (12/494) range from individual studies 0-7.4%]. Conclusion:Even though the outcome of parvovirus B19 in pregnancy in most cases is favorable, there is some supportive data that fetal parvovirus B19 infection can cause central nervous system damage. Future prospective studies needs to be conducted to address this issue.

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Long-term neurodevelopmental outcome after intrauterine transfusion for the treatment of fetal hemolytic disease

Cited by 110 publications

References 11 publications

Early intrauterine transfusion in severe red blood cell alloimmunization

Early intrauterine transfusion in severe red blood cell alloimmunization

Therapeutic management of fetal anemia: review of standard practice and alternative treatment options

Parvovirus B19 Infection in Pregnancy: Implications for Childhood Outcomes?

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