Twenty-Four Cordocenteses in One Woman

Abstract

We report on 2 consecutive pregnancies in a woman with a history of neonatal death secondary to Rhesus alloimmunization. Her first subsequent pregnancy was complicated by fetal hydrops at 20 weeks of gestation. The fetus received a total of 11 intrauterine transfusions, and was delivered at 38 weeks. In the patient’s next pregnancy, the fetus developed hydrops at 18 weeks of gestation. Thirteen intrauterine transfusions were given to correct fetal anemia, and a healthy baby was delivered at 38 weeks of gestational age. Continuation of intravascular transfusion therapy may represent a reasonable alternative to selective premature delivery even in cases with highly aggressive maternal Rhesus alloimmunization.

Fetal cardiac contractility before and after intrauterine transfusion

“…In 1999 Ulm et al described two pregnancies in the same woman where they performed 11 and 13 transfusions, respectively32. In their case report they suggest that continuation of intravascular therapy until term may represent a reasonable alternative to selective premature delivery even in cases with highly aggressive maternal rhesus alloimmunization.…”

Intravenous Fetal Exchange Transfusion before 22 Weeks of Gestation in Early and Severe Red-Cell Fetomaternal Alloimmunization

“…To date, intravascularfetal transfusion (IVT) is the only available therapeutic option in severe red blood cell alloimmunization remote from term with an average neonatal survival rate of 80% [3,6]. Fetal transfusions have occasionally been performed as early as at 18 weeks of gestation [7][8][9], but there is not data concerning the results of such an approach in the second trimester. Furthermore, there is concern that direct IVT might lead to circulatory overload and cardiac decompensation, contributing to increased fetal losses in hydropic fetuses [10], and this risk might be reduced with intravenous fetal exchange transfusion (IFET) [11].…”

Análise dos resultados dos procedimentos invasivos para estudo do cariótipo fetal

“…Cordocentese é um procedimento em que a amostra de sangue fetal é retirada através da punção percutânea do cordão umbilical, podendo subsidiar pesquisas de alterações cromossômicas (11,147,148) e o diagnóstico e tratamento da anemia fetal (149)(150)(151) . Além do diagnóstico de hemoglobinopatias, serve também para confirmação ou exclusão de mosaicismo (em BVC ou amniocentese) e infecções fetais (15,(152)(153)(154)(155)(156)(157) .…”