Journal articles: 'Blood transfusion intrauterine'

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Adama van Scheltema, P. N., and D. Oepkes. "Intrauterine blood transfusion." ISBT Science Series 5, no. 1 (June 10, 2010): 1–6. http://dx.doi.org/10.1111/j.1751-2824.2010.01396.x.

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Indersen, Amitha. "Fetal Intrauterine Transfusion." World Journal of Anemia 1, no. 1 (2017): 27–29. http://dx.doi.org/10.5005/jp-journals-10065-0006.

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ABSTRACT Fetal anemia is a recognizable and treatable condition. It requires identification of the etiology to plan a comprehensive treatment strategy. Fetal blood transfusions help tide over crisis and avert fetal cardiovascular decompensation or deterioration due to the anemia. Based on the cause and the fetal condition, the timing and requirement for transfusion are determined. At present, noninvasive monitoring with fetal middle cerebral arterial Doppler peak systolic velocity is the standard for monitoring and diagnosis of fetal anemia. How to cite this article Indersen A. Fetal Intrauterine Transfusion. World J Anemia 2017;1(1):27-29.

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BOYKO, N. V., G. YU MODEL, and V. I. ALEKHINA. "FEATURES OF ADAPTATION OF NEWBORNS WHO HAVE HAD INTRAUTERINE BLOOD TRANSFUSIONS." Kuban Scientific Medical Bulletin 25, no. 3 (July 26, 2018): 34–39. http://dx.doi.org/10.25207/1608-6228-2018-25-3-34-39.

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Aim. To assess the adaptive capacity of newborns who have had intrauterine blood transfusions.Materials and methods. The study included 40 newborns who underwent intrauterine intravascular blood transfusion due to hemolytic disease of the fetus RH-factor.Results. The percentage of antenatal fetal losses in hemolytic disease is significantly reduced. Intravascular blood transfusion allowed the fetus to prolong the pregnancy for at least 32 weeks. Survival of newborns with hemolytic disease has significantly increased. Conducting intrauterine blood transfusions leads to a decrease in the frequency and multiplicity of postpartum blood transfusions.Conclusion. With timely delivery and adequate use of high-tech methods of treatment, both intrauterine and postnatal, it is possible in 88% of cases to preserve the life of the newborn with satisfactory rates of physical and neuropsychological development.

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Fox, Karin A., and George Saade. "Fetal Blood Sampling and Intrauterine Transfusion." NeoReviews 13, no. 11 (November 2012): e661-e669. http://dx.doi.org/10.1542/neo.13-11-e661.

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Jean Sala, D., Kenneth J. Moise, Valerie E. Weber, and Leslie Cordella-Simon. "Maternal Blood Donation for Intrauterine Transfusion." Journal of Obstetric, Gynecologic & Neonatal Nursing 21, no. 5 (September 1992): 365–74. http://dx.doi.org/10.1111/j.1552-6909.1992.tb01753.x.

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Musemeche, Catherine A., and Marleta Reynolds. "Necrotizing enterocolitis following intrauterine blood transfusion." Journal of Pediatric Surgery 26, no. 12 (December 1991): 1411–12. http://dx.doi.org/10.1016/0022-3468(91)91050-9.

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Dassios, Theodore, Kamal Ali, Ann Hickey, and Anne Greenough. "Transient iatrogenic heart block following foetal intracardiac transfusion for severe twin anaemia-polycythaemia sequence." Case Reports in Perinatal Medicine 5, no. 2 (September 1, 2016): 127–29. http://dx.doi.org/10.1515/crpm-2016-0004.

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Abstract Background: Intrauterine blood transfusion is an important treatment of foetal anaemia. Although the standard access to the foetal vasculature for transfusion is the umbilical vein, the intracardiac route is used when foetal or placental positions make other accesses technically challenging. Intrauterine, intracardiac blood transfusion is associated with complications including haemopericardium, damage to cardiac tissues and foetal bradycardia. Highlights of the present report: We report a case of monochorionic twins with twin anaemia-polycythaemia sequence (TAPS). Intracardiac, intrauterine blood transfusion of the donor twin was complicated by haemopericardium and sustained bradycardia which necessitated delivery by emergency caesarean section. Postnatally, the bradycardia was sustained and was diagnosed electrocardiographically as heart block, which spontaneously reversed on the second day after birth. The management of heart block in the neonatal period is discussed. Conclusion: Foetal intracardiac intrauterine blood transfusion can be associated with transient congenital heart block (CHB).

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Ng, K. H., T. T. Lee, and Y. S. Soo. "An Alternative Technique of Intrauterine Blood Transfusion." Journal of The Asian federation of Obstetrics and Gynaecology 1, no. 2 (May 24, 2010): 155–57. http://dx.doi.org/10.1111/j.1447-0756.1970.tb00146.x.

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Agra, Isabela, Antonio Amorim Filho, Lawrence Lin, Sckarlet Biancolin, Rossana Francisco, and Maria Brizot. "Parameters Associated with Adverse Fetal Outcomes in Parvovirus B19 Congenital Infection." Revista Brasileira de Ginecologia e Obstetrícia / RBGO Gynecology and Obstetrics 39, no. 11 (September 25, 2017): 596–601. http://dx.doi.org/10.1055/s-0037-1606859.

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Objective To investigate the clinical and sonographic parameters associated with adverse fetal outcomes in patients with congenital parvovirus B19 infection managed by intrauterine transfusion. Methods This was a single-center retrospective study conducted from January 2005 to December 2016 that assessed patients with singleton pregnancies with fetal parvovirus infection confirmed by a polymerase chain reaction of the amniotic fluid or fetal blood samples who underwent at least one intrauterine transfusion. The maternal characteristics, sonographic findings and parameters related to intrauterine transfusion were compared between the two groups (recovery/non-recovery), who were categorized based on fetal response after in-utero transfusions. Progression to fetal death or delivery without fetal recovery after the transfusions was considered non-recovery and categorized as an adverse outcome. Results The final analysis included ten singleton pregnancies: seven of which were categorized into the recovery group and three of which into the non-recovery group. The baseline characteristics were similar between the groups. All fetuses were hydropic at the time of diagnosis. No significant differences related to sonographic or intrauterine transfusion parameters were identified between the groups; however, the non-recovery group tended to have an increased number of sonographic markers and lower fetal hemoglobin and platelet levels before the transfusion. Conclusion We were unable to firmly establish the clinical or sonographic parameters associated with adverse fetal outcomes in patients with parvovirus infection managed with intrauterine transfusions; however, edema, placental thickening and oligohydramnios may indicate greater fetal compromise and, subsequently, adverse outcomes. However, further studies are necessary, mainly due to the small number of cases analyzed in the present study.

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Bondarenko, N. P., V. P. Lakatosh, Ya M. Vitovsky, T. T. Narytnyk, and P. V. Lakatosh. "Modern methods of treatment of intrauterinenon-immune fetal hydropsinduced by parvovirus infection." HEALTH OF WOMAN, no. 5-6(151-152) (July 30, 2020): 43–47. http://dx.doi.org/10.15574/hw.2020.151-152.43.

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During ultrasonography examinationfetuses infected by parvovirus B19, we have established 36/129 (27.9%) cases of non-immune hydrops in the different periods of pregnancy.The hyperdynamic type of blood flow in fetal middle cerebral arterial was observed in fetuses at the second trimester. Measurement of fetal middle cerebral arteria peak systolic velocity was started at 18 weeks of gestationonce a week in pregnant women who were infected by parvovirus B19. During our study were found 17 cases of severe fetal anemia which manifested after 18 weeks of gestation.Intrauterine transfusions were performed for 11 pregnant women with parvovirus induced fetal hydrops whose gestation age were between 22.4 -25.7 (average 24.0±0.2). After cordocentesis11 cases of severe fetal anemia were confirmed.In the last 6 cases fetuses were diagnosed terminal condition due to women`s refusal of intrauterine transfusion or untimely admission to the hospital. Taking to account the results of study, the efficacy of treatment non-immune hydrops infected by parvovirus B19 with severe fetal anemia and outcomes were evaluated and analyzed. Successful treatment of parvovirus-induced fetal non-immune hydrops in the second trimester of pregnancy has been found in 72.7% cases (OR=95%) after intrauterine transfusion compared to 100% lethal rate in fetuses with non-immune hydrops and severe anemia who were not treated. Criteria for effectiveness of intrauterine transfusion are in time diagnosis of severe fetal anemia in infected fetus with non-immune hydrops, determine the optimal gestation age for intrauterine transfusion, indicators of viremia in umbilical cord blood, the compensatory capacity of the fetus based on Doppler metric indicator of middle cerebral arterial peak systolic velocity and changes blood flow in ductus venous of the fetus. It helps to reduce perinatal loss. Keywords: parvovirus infection, non-immune hydrops fetalis, intrauterine transfusion.

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Rivers, Angela E., Douglas Richard, Neil Harris, David H. K. Chui, William B. Slayton, Keri Baacke, and Susan Lynn Staba. "Unrelated Donor Umbilical Cord Blood Transplant Following Intrauterine Transfusions for Treatment of Alpha Thalassemia Major." Blood 108, no. 11 (November 16, 2006): 5403. http://dx.doi.org/10.1182/blood.v108.11.5403.5403.

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Abstract Homozygous α0-thalassemia (deletion of all 4 α-globin genes) results in Hb Bart’s (γ4 tetramers). The high oxygen affinity of Hgb Bart’s leads to severe hypoxia inutero with resulting profound edema (hydrops) and congestive heart failure. Almost universally fetal death occurs prior to diagnosis, therefore not allowing the opportunity for treatment. Advancement of maternal-fetal medicine and neonatal ultrasound has led to the possibility of in utero diagnosis and treatment with inrauterine transfusions. Also, cases of premature infants surviving and undergoing chronic transfusion therapy have been reported. Hematopoietic stem cell transplant (HSCT) has become increasingly used in the cure of beta thalassemia, and provides the potential to cure a0thalassemia as well. To date, 3 reported cases of a0thalassemia have been successfully treated with HSCT. Two children underwent matched sibling bone marrow transplant at 20 and 21 months of age and one underwent a 5/6 HLA matched sibling umbilical cord blood transplant (UCBT). One child had received intrauterine transfusions. We report a case of an infant with a0thalassemia successfully treated with intrauterine transfusion therapy followed by unrelated donor UCBT. The child’s mother, of Cambodian descent, presented to the obstetrician at 23 weeks with concerns of decreased fetal movement. Fetal ultrasound revealed a thickened placenta and hydrops fetalis. Based on the family’s nationality and history of previous fetal loss, the suspicion of a0thalassemia was raised. Umbilical cord blood sampling revealed a hypochromic, microcytic anemia with target cells. The hemoglobin electrophoresis demonstrated Hgb Barts and Portland. Subsequent genotyping confirmed deletion of all 4 α-globin genes. Options presented to the family included termination of pregnancy as well as the option of intrauterine transfusion followed by either chronic transfusion therapy with iron chelation or the possibility of HSCT. The patient received three intrauterine transfusions prior to delivery at 32 weeks gestation. A poor physical profile, non-reassuring heart rate and breech position led to the premature delivery. Apgars were 1 at one minute, 6 at five minutes, and 9 at ten minutes. The baby was admitted to the NICU and required mechanical ventilation for two days. The hospital course was relatively uneventful and included red blood cell transfusion. After discharge, he was maintained with intermittent transfusions until 6 months of age. Following informed consent, he was conditioned for transplant with busulfan, cytoan and rabbit ATG. Since the infant lacked an HLA matched sibling, he received a 5/6 HLA matched unrelated donor umbilical cord blood unit delivering 11.8 × 107 nucleated cells/kg. Neutrophil engraftment (ANC>500) was achieved on day + 15. FK506 and methotrexate 5mg/m2 on days 1, 3 and 6 was utilized for GVHD prophylaxis. His course was complicated by moderate venoocclusive disease, small subdural hemorrhage, and CMV and adenovirus viremia. He has not had any evidence of graft versus host disease. Initial chimerism (RFLP) showed approximately 63% donor derived cells, and subsequent testing showed increasing chimerism and 100% T-cell engraftment. He clinically is doing very well post transplant. This case demonstrates that intrauterine transfusion followed by unrelated donor UCBT is feasible for the treatment of a0thalassemia.

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Hashimoto, B., R. A. Filly, P. W. Callen, and J. T. Parer. "Absorption of fetal intraperitoneal blood after intrauterine transfusion." Journal of Ultrasound in Medicine 6, no. 8 (August 1987): 421–23. http://dx.doi.org/10.7863/jum.1987.6.8.421.

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Lindenburg, Irene T. M., Inge L. van Kamp, and Dick Oepkes. "Intrauterine Blood Transfusion: Current Indications and Associated Risks." Fetal Diagnosis and Therapy 36, no. 4 (2014): 263–71. http://dx.doi.org/10.1159/000362812.

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Wielgos, Miroslaw, and Robert Brawura-Biskupski-Samaha. "Intrauterine Transfusions in FHD: When and How?" Donald School Journal of Ultrasound in Obstetrics and Gynecology 7, no. 4 (2013): 481–83. http://dx.doi.org/10.5005/jp-journals-10009-1320.

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ABSTRACT Intrauterine fetal blood transfusions still remain the gold standard of prenatal therapy in severe cases of fetal hemolytic disease due to mother-fetus immunization. Middle cerebral artery-peak systolic velocity (MCA-PSV) measurements plays the most important role in diagnosing the disease. A value of MCA-PSV >1.5 allows us to diagnose severe or moderate anemia and prompts us to treat the patient. The time of subsequent transfusions is estimated by the hemoglobin level directly after the transfusion and the fact that the concentration of fetal hemoglobin in blood decreases at a rate of 0.3 g% per day. Even though effective, these procedures carry with them major risks and that is why prophylaxis is essential. How to cite this article Wielgos M, Brawura-Biskupski- Samaha R. Intrauterine Transfusions in FHD: When and How? Donald School J Ultrasound Obstet Gynecol 2013;7(4):481-483.

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Arora, Devendra. "Fetal Blood Transfusion: The Saviour." Annals of the National Academy of Medical Sciences (India) 54, no. 01 (January 2018): 011–32. http://dx.doi.org/10.1055/s-0040-1712819.

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AbstractThe purpose of this oration is to discuss the modality of highly specialized Intra vascular fetal blood transfusion and its various sites to perform fetal blood transfusion with the role of middle cerebral artery-peak systolic velocity (MCA-PSV), as measured by Doppler ultrasound, in managing fetal anemia in Rh-alloimmunized pregnancies. Intra-uterine fetal blood transfusion was performed in such anemic fetuses to tide over the crisis of fetal immaturity till considered fit for extra-uterine survival. Rh-alloimmunized pregnancies with or without hydrops reporting to our tertiary care institute from January, 2005 to December, 2015 were screened by Doppler ultrasound to estimate MCA-PSV to detect fetal anemia. During follow-up, if the fetus developed MCA-PSV values more than 1.5 MoM for the gestational age, fetal blood sampling through cordocentesis was performed to confirm fetal anemia. This was followed by intra-uterine fetal blood transfusion to all the anemic fetuses at the same sitting. The neonatal outcome was evaluated by recording gestational age at the time of delivery, duration of gestational time gained, and need for blood transfusion in the neonatal period. A total of 226 Rh-alloimmunized pregnancies were evaluated. Three hundred ninety six intra-uterine fetal blood transfusions were performed. In their neonatal period, 137 neonates received blood transfusion. Intrauterine fetal death occurred in 11 fetuses out of which 7 were grossly hydropic fetus. Favorable neonatal outcome was recorded in the rest including 42 hydropic fetuses. The clinical outcome of these pregnancies justifies the use of Doppler studies of MCA-PSV in detecting fetal anemia as these were found to correlate well. Intra-uterine fetal blood transfusion in the anemic fetuses is the only hope of prolonging pregnancy salvaging such fetuses.

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Yinon, Y., J. Visser, E. N. Kelly, R. Windrim, H. Amsalem, P. G. R. Seaward, and G. Ryan. "Early intrauterine transfusion in severe red blood cell alloimmunization." Ultrasound in Obstetrics and Gynecology 36, no. 5 (May 27, 2010): 601–6. http://dx.doi.org/10.1002/uog.7696.

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Zelyanina, Е. A., O. V. Khoroshkeeva, K. V. Kostyukov, R. M. Gasanova, D. M. Belousov, O. A. Bystrykh, N. K. Tetruashvili, and E. L. Bokeriya. "Features of the cardiovascular system of fetuses and newborns after intrauterine intravascular blood transfusion." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 66, no. 1 (March 31, 2021): 52–58. http://dx.doi.org/10.21508/1027-4065-2021-66-1-52-58.

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Intrauterine intravascular blood transfusion is an effective and relatively safe treatment method for severe fetal anemia. This technique have been used for more than 30 years already, however, there are no systematic works devoted to the features of the cardiovascular system in fetuses and newborns after intrauterine intravascular blood transfusion. The authors have decided to study this problem and have conducted a prospective trial of fetuses and children (n=34) with hemolytic anemia who underwent intrauterine blood transfusion. To assess the condition of the cardiovascular system, the scientists have carried out an ultrasound examination of the heart, which results have revealed pathological changes: dilatation of the cardiac cavities, myocardial hypertrophy, hydropericardium, cardiomegaly still present in the postnatal period. The scientists have used fetal and neonatal therapy for the patients with these pathologies. In the case of late correction of severe fetal anemia, there was a progressive deterioration in the condition of the fetus and remodeling of the cardiovascular system, which indicates the need for timely diagnosis. Based on the results of the study, the scientists have developed the protocols for ultrasound diagnostics of fetuses and newborns with moderate and severe anemia.

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Berman, A. A., A. V. Vazhenin, O. N. Chernova, and N. V. Bashmakova. "THE ROLE OF MAGNETIC RESONANCE IMAGING IN THE PERINATAL ASSESSMENT OF THE CONDITION FETAL CNS WITH HEMOLYTIC DISEASE, WHO RECEIVED TREATMENT BY INTRAUTERINE INTRAVASCULAR BLOOD TRANSFUSION." Diagnostic radiology and radiotherapy, no. 3 (November 21, 2018): 36–42. http://dx.doi.org/10.22328/2079-5343-2018-9-3-36-42.

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Objective: to determine the role of magnetic resonance imaging (MRI) in the pathomorphological evaluation of focal changes in the central nervous system (CNS) of fetuses with hemolytic disease before and after treatment, by intrauterine intravascular blood transfusion, and to compare the MRI data of fetuses with ultrasound neurosonography (NSH) newborns. The study included 45 pregnant women and their 45 newborns. Patients are divided into 2 groups. The main group: 30 pregnant women (mean gestation period 32,1 weeks) with hemolytic disease of the fetus who underwent intrauterine intravascular blood transfusion and their 30 newborns with hemolytic disease of the newborn. In this group, comparative MRI examinations of the central nervous system were performed using a protocol including fast MP sequences based on T1 and T2-weighted images, as well as the DWI pulse sequence, both before treatment (intrauterine intravascular blood transfusion of the fetus), and after treatment (regardless of the multiplicity of intrauterine intravascular transfusion — before delivery). The comparison group comprised 15 pregnant women (mean gestation period of 38,6 weeks) with no signs of hemolytic disease, examined by MRI for other indications (concomitant pathology of pregnancy) and their 15 newborns, comparable in gestational age to the main group. The obstetric anamnesis, the MRI data of the central nervous system of fetuses before the treatment (the first intrauterine intravascular transfusion) and after the treatment (before the delivery) and the results of ultrasound for the first day of life were analyzed. When comparing the MRI data of changes in the central nervous system, in the main group (in fetuses with bladder) in relation to the comparison group before treatment (the first intrauterine, intravascular transfusion), a high incidence of focal changes in the brain substance in the main group was revealed. The use of MRIdiagnostics demonstrates a decrease in the risk of development of PCNC in ischemic type, in dynamics before and after treatment. Based on the MRI diagnostic data of the fetal CNS, it is possible to judge the prognosis of the outcomes of hemolytic disease of the fetus, in comparison with the neonatal neurosonography data for the first day.

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Fisk, Nicholas M., Rachel Gitau, Jeronima M. Teixeira, Xenophon Giannakoulopoulos, Alan D. Cameron, and Vivette A. Glover. "Effect of Direct Fetal Opioid Analgesia on Fetal Hormonal and Hemodynamic Stress Response to Intrauterine Needling." Anesthesiology 95, no. 4 (October 1, 2001): 828–35. http://dx.doi.org/10.1097/00000542-200110000-00008.

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Background Whether the fetus can experience pain remains controversial. During the last half of pregnancy, the neuroanatomic connections for nociception are in place, and the human fetus mounts sizable stress responses to physical insults. Analgesia has been recommended for intrauterine procedures or late termination, but without evidence that it works. The authors investigated whether fentanyl ablates the fetal stress response to needling using the model of delayed interval sampling during intrahepatic vein blood sampling and transfusion in alloimmunized fetuses undergoing intravascular transfusion between 20 and 35 weeks. Methods Intravenous fentanyl (10 microg/kg estimated fetal weight x 1.25 placental correction) was given once at intrahepatic vein transfusion in 16 fetuses, and changes (posttransfusion - pretransfusion) in beta endorphin, cortisol, and middle cerebral artery pulsatility index were compared with intrahepatic vein transfusions without fentanyl and with control transfusions at the placental cord insertion. Results Fentanyl reduced the beta endorphin (mean difference in changes, -70.3 pg/ml; 95% confidence interval, -121 to -19.2; P = 0.02) and middle cerebral artery pulsatility index response (mean difference, 0.65; 95% confidence interval, 0.26-1.04; P = 0.03), but not the cortisol response (mean difference, -10.9 ng/ml, 95% confidence interval, -24.7 to 2.9; P = 0.11) in fetuses who had paired intrahepatic vein transfusions with and without fentanyl. Comparison with control fetuses transfused without fentanyl indicated that the beta endorphin and cerebral Doppler response to intrahepatic vein transfusion with fentanyl approached that of nonstressful placental cord transfusions. Conclusions The authors conclude that intravenous fentanyl attenuates the fetal stress response to intrahepatic vein needling.

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Mikhailov, A. V., A. N. Romanovsky, T. A. Kashtanova, A. A. Kuznetsov, I. V. Kyanksep, V. E. Volchenkova, and A. A. Savel’eva. "Twin anemia polycythemia sequence – modern approaches to diagnosis and antenatal correction." Voprosy ginekologii, akušerstva i perinatologii 20, no. 2 (2021): 134–40. http://dx.doi.org/10.20953/1726-1678-2021-2-134-140.

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Twin anemia polycythemia sequence (TAPS) is a specific complication of the monochorionic multiple birth, which is based on chronic feto-fetal blood transfusion over placental vascular anastomoses, and the main clinical symptom is discordant fetal hemoglobin level in the absence amniotic fluid imbalance. Currently, there is no generally recognized consensus on the optimal treatment tactics. Dynamic observation, labor, intrauterine blood transfusion, selective fetocide, fetoscopic laser coagulation of placental vascular anastomoses are applied, although the latter is recognized by the majority of researchers as the most promising method for treating TAPS. There are disagreements in estimating the frequency of perinatal morbidity and mortality during pregnancy, complicated by the development of TAPS, and their real value has not yet been completely defined. Key words: intrauterine transfusion, Solomon method, monochorionic twins, twin anemia polycythemia sequence, fetoscopic laser coagulation

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Maki, Yohei, Junko Ushijima, Seishi Furukawa, Hiroko Inagaki, Hiroyuki Takenouchi, Shouichi Fujimoto, and Hiroshi Sameshima. "Plasmapheresis for the Treatment of Anti-M Alloimmunization in Pregnancy." Case Reports in Obstetrics and Gynecology 2020 (February 7, 2020): 1–4. http://dx.doi.org/10.1155/2020/9283438.

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Intrauterine transfusion is the standard antenatal treatment for a fetus with severe anemia. Plasmapheresis is an alternative treatment for cases with a history of severe hemolytic disease of the fetus and newborns at less than 20 weeks of gestation. There is only one previous report of plasmapheresis for the anti-M alloimmunization in pregnancy, and we report here on the successful treatment of plasmapheresis for anti-M alloimmunization. A woman with a history of intrauterine fetal death at 24 weeks of gestation due to severe fetal anemia caused by anti-M alloimmunization received plasmapheresis once or twice a week from 14 weeks of gestation onward. An intrauterine blood transfusion was conducted at 28 weeks, and a cesarean section was performed at 31 weeks. The infant had anemia and jaundice but was discharged at day 46. Plasmapheresis may delay the development of fetal anemia and reduce the risk of early and repeat intrauterine transfusion in cases of anti-M alloimmunization in pregnancy.

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Vlachodimtropoulou Koumoutsea, Evangelia, Maciej W. Garbowski, Tim VanMieghem, Shelley Solomon, Nimrah Abbasi, Gareth Seaward, Rory Windrim, et al. "Maternal Red Blood Cell Alloimmunization Managed with Intrauterine Blood Transfusion: Predictors of Poor Outcome." Blood 136, Supplement 1 (November 5, 2020): 27–28. http://dx.doi.org/10.1182/blood-2020-139502.

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Background: The rhesus (Rh) and Kell blood group systems are the most common of over 50 different antigens capable of causing maternal red blood cell (RBC) alloimmunization and severe fetal hemolytic disease. Anti-K and anti-D are responsible for a significant proportion of fetal anemia requiring intrauterine transfusion (IUT). Whilst IUT of packed RBCs improves neonatal survival and morbidity, clinical prognostic indicators are lacking. Our primary objective was to identify predictors of adverse outcome. Methods: We conducted a retrospective single-center study at Mount Sinai Hospital (MSH), Toronto, Canada. All pregnant patients alloimmunized with anti-K and anti-D as a single antibody, between 1991 and 2018 were included. Data were obtained from patient medical records, ultrasound reports and information from the transfusion medicine laboratory. Data included maternal demographics, antibody titers, pregnancy history, number of IUTs, hemoglobin (HB) concentration at the beginning and end of all IUTs. Neonatal outcomes included survival, mode of delivery, gestational age at delivery, birth weight, HB at birth and need for neonatal transfusion, phototherapy or intravenous immunoglobulins (IVIG). Our primary outcome was the composite outcome of stillbirth or neonatal death (SB/NND). We also constructed a secondary outcome consisting of top-up neonatal transfusion, exchange transfusion, phototherapy, or use of IVIG. Medians and interquartile ranges (IQR) or mean±SD were used as summary statistics and compared by Mann-Whitney or t-test; p<0.05 was statistically significant. Outcome predictors were identified using multivariable logistic or linear regression analysis; accounting for patient level clustering by marginal Generalized Estimating Equation did not significantly affect variables. Data were analyzed using SPSS. Results: 116 women with 128 pregnancies and 425 IUTs with anti-K or anti-D as a single antibody were identified. Median maternal age was 31 years (27.0-35.0) for anti-K and 32 years (23.6-40.6) for anti-D. The gestational age at 1st IUT differed significantly between anti-K and anti-D (24.3 vs 28.7 weeks respectively, p=0.004). Women with anti-K antibodies required more IUTs than women with anti-D (3.84 vs 3.12 IUTs, p=0.036) and HB at 1st IUT was significantly lower in the anti-K group (5.10 vs 7.05 g/dL, p=0.001) (Table 1). Following initiation of IUT, the time from 1st IUT to delivery was 69.6 days in the anti-K group and 54.6 in the anti-D group (p=0.06). The daily decrease of HB between 1st and 2nd IUT (as a marker of disease severity), development of fetal hydrops and severe preterm birth did not differ significantly between the two groups. Mean gestation age at delivery was 35.0 weeks in the anti-K and 36.0 weeks in the anti-D group (p=0.28), with 87.1% and 93.9% survival (p=0.37), respectively. The proportion of neonates requiring phototherapy, IVIG and exchange/top-up transfusion was comparable across the two antibody groups (Table 1). Regression analysis showed that delivery occurred sooner if HB dropped more rapidly between the first two IUTs (p=0.01). Each additional transfusion gained on average 22.5 days in utero (Table 2). In multivariable analysis, gestational age at 1st IUT was the only predictor of a SB/NND outcome (adjusted OR 0.79 [95%CI 0.67-0.93]; p=0.006). With 1st IUT at 23 weeks, the risk of SB/NND was 8%, but only 2.5% at 28 weeks and <0.01% at 36 weeks (Table 3). Gestational age at delivery (adjusted OR 1.11 [95%CI 1.00 to 1.23]; p=0.046) and HB at 1st IUT (adjusted OR 0.84 [95%CI 0.72 to 0.99]; p=0.038) were the only predictors of a composite adverse blood product requirement/intervention outcome (Table 4). The odds of blood product requirement/intervention postnatally at 1st IUT (median HB at 1st IUT of 6.6g/dL) at 28 weeks were 43% and increased by a further 38% for delivery at 34 weeks. Conclusion: The earlier in gestation that IUTs are implemented, the higher the odds of a SB/NND; however the later the gestation at delivery, the greater the odds of the neonate requiring blood products post-partum. The greater the HB drop between the 1st and 2nd IUT, the shorter the 'time between the first IUT and delivery', which increases the odds of a SB/NND outcome. Disclosures Garbowski: Vifor Pharma: Consultancy, Membership on an entity's Board of Directors or advisory committees; Imara: Consultancy. Shehata:Ferring: Honoraria.

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Sheridan, Todd, Frederic B. Askin, and Hongxiu Ji. "Multinucleated Foreign Body Giant Cells in Placental Membrane." Pediatric and Developmental Pathology 8, no. 4 (July 2005): 493–96. http://dx.doi.org/10.1007/s10024-005-0027-6.

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We report the pathologic finding of a multinucleated foreign body giant cell reaction to squames and fetal hair in the placental membranes in a 37-week 1-day intrauterine gestation. This reaction appeared to have developed in association with repeated intrauterine procedures performed in the third trimester, including cordocentesis for fetal blood sampling, intrauterine blood transfusion, and amnioreduction for polyhydramnios. This type of reaction most likely was directed to prolonged amniotic fluid leakage that occurred spontaneously or after intrauterine procedures in the second half of the second trimester and the third trimester. Careful examination of the placental membranes and recognition of the foreign body giant cell reaction may provide etiologic insight in cases of unexplained oligohydramnios.

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Al-Riyami, Arwa Z., Mouza Al-Salmani, Sabria N. Al-Hashami, Sabah Al-Mahrooqi, Ali Al-Marhoobi, Sumaiya Al-Hinai, Saif Al-Hosni, Sathiya M. Panchatcharam, and Zainab A. Al-Arimi. "Intrauterine Fetal Blood Transfusion: Descriptive study of the first four years’ experience in Oman." Sultan Qaboos University Medical Journal [SQUMJ] 18, no. 1 (April 4, 2018): 34. http://dx.doi.org/10.18295/squmj.2018.18.01.006.

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Objectives: Haemolytic disease of the fetus and newborn (HDFN) causes hydrops fetalis. The successful treatment of HDFN has been reported with intrauterine blood transfusion (IUT). This study aimed to describe the initial experience with IUT procedures in Oman. Methods: This retrospective observational study took place at the Royal Hospital and Sultan Qaboos University Hospital Blood Bank, Muscat, Oman, and included all women who underwent IUT procedures in Oman between March 2012 and March 2016. Gestational and neonatal outcomes were assessed, including complications, morbidity, neurodevelopmental sequelae and mortality. Results: A total of 28 IUT procedures for 13 fetuses carried by 11 women were performed. Gestational age at the time of referral ranged from 13–30 weeks, while the median gestational age at first IUT procedure was 26 weeks (range: 19–30 weeks). Indications for the procedure included HDFN caused by anti-D (n = 6), a combination of anti-D and anti-C (n = 4), anti-K (n = 1) and anti-Jsb (n = 1) antibodies and nonimmune hydrops fetalis due to a congenital parvovirus infection (n = 1). Median fetal haemoglobin levels at the beginning and end of the procedure were 4.6 g/dL and 12.8 g/dL, respectively. Most procedures were transplacental intravascular transfusions through the placental umbilical cord root (71.4%), followed by transamniotic intravascular transfusions (14.3%). The overall survival rate was 61.5%, with five deaths; of these, four were intrauterine and one was an early neonatal death due to non-resolved hydrops and severe cardiac dysfunction. Conclusion: As a relatively novel obstetric procedure in Oman, IUT seems to result in a favourable outcome for hydropic fetuses.

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Lasker, Michelle, Keith Eddleman, and Ashfaq Toor. "Neonatal Hepatitis and Excessive Hepatic Iron Deposition Following Intrauterine Blood Transfusion." American Journal of Perinatology 12, no. 01 (January 1995): 14–17. http://dx.doi.org/10.1055/s-2007-994390.

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26

Keckstein, Georg, Sonja Tschurtz, Volker Schneider, Wolfgang Mütter, Rainer Terinde, and Wolf-Dietrich Jonatha. "Umbilical cord haematoma as a complication of intrauterine intravascular blood transfusion." Prenatal Diagnosis 10, no. 1 (January 1990): 59–65. http://dx.doi.org/10.1002/pd.1970100109.

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27

Zwiers, C., I. T. M. Lindenburg, F. J. Klumper, M. de Haas, D. Oepkes, and I. L. Van Kamp. "Complications of intrauterine intravascular blood transfusion: lessons learned after 1678 procedures." Ultrasound in Obstetrics & Gynecology 50, no. 2 (August 2017): 180–86. http://dx.doi.org/10.1002/uog.17319.

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Mizuuchi, Masahito, Jun Murotsuki, Keisuke Ishii, Ryo Yamamoto, Jun Sasahara, Seiji Wada, Yuichiro Takahashi, Masahiko Nakata, Takeshi Murakoshi, and Haruhiko Sago. "Nationwide survey of intrauterine blood transfusion for fetal anemia in Japan." Journal of Obstetrics and Gynaecology Research 47, no. 6 (March 15, 2021): 2076–81. http://dx.doi.org/10.1111/jog.14746.

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29

Wallace, Alexandra H., Stuart R. Dalziel, Brett R. Cowan, Alistair A. Young, Kent L. Thornburg, and Jane E. Harding. "Long-term cardiovascular outcome following fetal anaemia and intrauterine transfusion: a cohort study." Archives of Disease in Childhood 102, no. 1 (September 23, 2016): 40–45. http://dx.doi.org/10.1136/archdischild-2016-310984.

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ObjectiveTo compare long-term cardiovascular outcomes in survivors of fetal anaemia and intrauterine transfusion with those of non-anaemic siblings.DesignRetrospective cohort study.SettingAuckland, New Zealand.ParticipantsAdults who received intrauterine transfusion for anaemia due to rhesus disease (exposed) and their unexposed sibling(s).ExposureFetal anaemia requiring intrauterine transfusion.Main outcome measuresAnthropometry, blood pressure, lipids, heart rate variability and cardiac MRI, including myocardial perfusion.ResultsExposed participants (n=95) were younger than unexposed (n=92, mean±SD 33.7±9.3 vs 40.1±10.9 years) and born at earlier gestation (34.3±1.7 vs 39.5±2.1 weeks). Exposed participants had smaller left ventricular volumes (end-diastolic volume/body surface area, difference between adjusted means −6.1, 95% CI −9.7 to −2.4 mL/m2), increased relative left ventricular wall thickness (difference between adjusted means 0.007, 95% CI 0.001 to 0.012 mm.m2/mL) and decreased myocardial perfusion at rest (ratio of geometric means 0.86, 95% CI 0.80 to 0.94). Exposed participants also had increased low frequency-to-high frequency ratio on assessment of heart rate variability (ratio of geometric means 1.53, 95% CI 1.04 to 2.25) and reduced high-density lipoprotein concentration (difference between adjusted means −0.12, 95% CI −0.24 to 0.00 mmol/L).ConclusionsThis study provides the first evidence in humans that cardiovascular development is altered following exposure to fetal anaemia and intrauterine transfusion, with persistence of these changes into adulthood potentially indicating increased risk of cardiovascular disease. These findings are relevant to the long-term health of intrauterine transfusion recipients, and may potentially also have implications for adults born preterm who were exposed to anaemia at a similar postconceptual age.

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Dajak, Slavica, Nina Ipavec, Mia Cuk, Branka Golubic Cepulic, Jela Mratinovic-Mikulandra, Josipa Milardovic, and Vedran Stefanovic. "The Outcome of Hemolytic Disease of the Fetus and Newborn Caused by Anti-Rh17 Antibody: Analysis of Three Cases and Review of the Literature." Transfusion Medicine and Hemotherapy 47, no. 3 (October 3, 2019): 264–71. http://dx.doi.org/10.1159/000503012.

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Background: Anti-Rh17 is a rare red blood cell (RBC) antibody to high-frequency antigens that may cause severe hemolytic disease of the fetus and newborn (HDFN). Despite the rarity of HDFN caused by Anti-Rh17, this antibody was reported in many different populations. Emergency transfusions, especially exchange transfusions, present a huge problem if no compatible RBCs of phenotype D-- are available. Methods: Here we report obstetrical histories of three women and describe their pregnancies complicated by anti-Rh17 antibodies. We summarized published cases of pregnancies complicated by anti-Rh17 and reviewed transfusion treatment and outcomes. Additionally, a simplified flowchart for the management of such pregnancies is proposed. Results: Four pregnancies were affected by severe HDFN, and three of them ended with perinatal death. In the fourth case, the baby was born hydropic and icteric and the condition was rapidly deteriorating. Emergency exchange transfusion was performed with incompatible O-negative RBC units in AB-negative plasma. The baby was discharged on the 14th day in good health. In the available literature, 15 women and 22 pregnancies were reported, 20 of them developed severe HDFN. According to the data, intrauterine transfusion for treatment of HDFN was the most common form of treatment with the donation of the mother’s blood. Different options for exchange transfusion were described, including incompatible RBCs. Conclusion: In more than 90% of described pregnancies of HDFN caused by anti-Rh17 antibody, transfusion treatment was required. Therefore, RBC from D-- phenotype has to be available. According to published data, in emergent circumstances when maternal and blood from donor with phenotype D-- is not available, incompatible exchange transfusion is a better choice than delaying transfusion when it is necessary. It is of essential importance that pregnancies with high risk of HDFN due to anti-Rh17 are managed by a multidisciplinary team (transfusion medicine specialist, obstetrician, neonatologist) in a highly specialized tertiary institution.

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Buckshee, K., N. Bhatla, and V. K. Paul. "Successful ultrasound-guided intrauterine blood transfusion in severe non-immune hydrops fetalis." International Journal of Gynecology & Obstetrics 32, no. 2 (June 1990): 153–56. http://dx.doi.org/10.1016/0020-7292(90)90481-y.

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Malinowski, W., W. Dec, and I. Biskup. "The Assessment of the Umbilical Blood Flow of the Surviving Twin after the Intrauterine Death of the Other Twin." Acta geneticae medicae et gemellologiae: twin research 45, no. 3 (July 1996): 383–86. http://dx.doi.org/10.1017/s0001566000000982.

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AbstractThis paper summarizes our experience with Doppler velocimetry in survivors of intrauterine co-twin demise. In the first trimester, ten dichorionic deaths occurred; none of the survivors developed flow disorders. During the second trimester, there were three intrauterine demises, two of them were monochorionic and the survivors developed flow disorders: one presented transitory venous flow aberration, the other one an impaired development of diastolic flow. In the third trimester, two intrauterine deaths occurred. One case of twin to twin transfusion syndrome (TTTS) was complicated by the donor's death and the recipient showed a loss of diastolic flow. The second one happened during a dichorionic twin pregnancy. The survivor presented high systolic/diastolic daily ratio (S/D = 7.8).

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Viëtor, Henk E., Eric Hallensleben, Simone P. M. J. van Bree, Ellen M. W. van der Meer, Suzanne E. J. Kaal, Jack Bennebroek-Gravenhorst, Humphrey H. H. Kanhai, Anneke Brand, and Frans H. J. Claas. "Survival of donor cells 25 years after intrauterine transfusion." Blood 95, no. 8 (April 15, 2000): 2709–14. http://dx.doi.org/10.1182/blood.v95.8.2709.

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Abstract Persistence of donor leukocytes in the circulation of recipients of intrauterine transfusion (IUT) has been observed up to 5 years after birth. The aim of this study was to determine whether transfusions with nonirradiated, nonleukocyte-depleted donor blood during the fetal period resulted in long-term immunomodulation of the recipient. Twenty-four surviving IUT recipients between 1966 and 1976 were tested for autoimmune disease and autoantibodies at follow-up. Ten had sex-mismatched donors and were therefore informative for chimerism studies using fluorescence in situ hybridization (FISH). Seven female recipients could be tested for chimerism using a Y- chromosome–specific polymerase chain reaction (PCR) because they received at least 1 IUT from a male donor. Nine recipients could be studied for cytotoxic T-lymphocyte precursor (CTLp) and helper T-lymphocyte precursor (HTLp) frequencies because the original donors were available for testing. All surviving IUT recipients were in good health at the time of the examination, and routine laboratory testing revealed no abnormalities. None of the IUT recipients were chimeric as determined by FISH analysis, but Y-chromosome–specific sequences were detected by PCR in 6 of the 7 women. However, the CTLp and HTLp frequencies of the IUT recipients against the donors were comparable to those of the controls. The current study provides evidence that IUT can result in the persistence of donor cells in the recipient for a period longer than 20 years but that it is not associated with immunotolerance or with signs of chronic antigenic stimulation.

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Viëtor, Henk E., Eric Hallensleben, Simone P. M. J. van Bree, Ellen M. W. van der Meer, Suzanne E. J. Kaal, Jack Bennebroek-Gravenhorst, Humphrey H. H. Kanhai, Anneke Brand, and Frans H. J. Claas. "Survival of donor cells 25 years after intrauterine transfusion." Blood 95, no. 8 (April 15, 2000): 2709–14. http://dx.doi.org/10.1182/blood.v95.8.2709.008k10_2709_2714.

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Persistence of donor leukocytes in the circulation of recipients of intrauterine transfusion (IUT) has been observed up to 5 years after birth. The aim of this study was to determine whether transfusions with nonirradiated, nonleukocyte-depleted donor blood during the fetal period resulted in long-term immunomodulation of the recipient. Twenty-four surviving IUT recipients between 1966 and 1976 were tested for autoimmune disease and autoantibodies at follow-up. Ten had sex-mismatched donors and were therefore informative for chimerism studies using fluorescence in situ hybridization (FISH). Seven female recipients could be tested for chimerism using a Y- chromosome–specific polymerase chain reaction (PCR) because they received at least 1 IUT from a male donor. Nine recipients could be studied for cytotoxic T-lymphocyte precursor (CTLp) and helper T-lymphocyte precursor (HTLp) frequencies because the original donors were available for testing. All surviving IUT recipients were in good health at the time of the examination, and routine laboratory testing revealed no abnormalities. None of the IUT recipients were chimeric as determined by FISH analysis, but Y-chromosome–specific sequences were detected by PCR in 6 of the 7 women. However, the CTLp and HTLp frequencies of the IUT recipients against the donors were comparable to those of the controls. The current study provides evidence that IUT can result in the persistence of donor cells in the recipient for a period longer than 20 years but that it is not associated with immunotolerance or with signs of chronic antigenic stimulation.

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Ivanova, A. V., S. Yu Zakharova, and L. A. Pestryaeva. "Specific features of red blood cell morphology in hemolytic disease neonates undergoing intrauterine intravascular blood transfusion." Rossiyskiy Vestnik Perinatologii i Pediatrii (Russian Bulletin of Perinatology and Pediatrics) 61, no. 1 (March 1, 2016): 42–45. http://dx.doi.org/10.21508/1027-4065-2016-61-1-42-45.

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36

Soothill, Peter. "Intrauterine blood transfusion for non-immune hydrops fetalis due to parvovirus B19 infection." Lancet 336, no. 8707 (July 1990): 121–22. http://dx.doi.org/10.1016/0140-6736(90)91642-n.

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37

Vatsla, Dadhwal, Deka Deepika, Gurunath Sumana, Mittal Suneeta, V. K. Paul, and A. Deorari. "Treatment of fetal anemia in Rh isoimmunized pregnancies with intrauterine fetal blood transfusion." Journal of Obstetrics and Gynecology of India 60, no. 2 (April 2010): 135–40. http://dx.doi.org/10.1007/s13224-010-0019-y.

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38

Oepkes, Dick, and Humphrey HH Kanhai. "Noninvasive assessment of fetal anaemia." Fetal and Maternal Medicine Review 7, no. 3 (August 1995): 143–57. http://dx.doi.org/10.1017/s0965539500001285.

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In pregnancies complicated by severe red cell alloimmunization, fetal haemolytic anaemia can lead to intrauterine demise as early as 17 weeks' gestation. Intrauterine intraperitoneal blood transfusion, introduced by Liley in 1963, proved to be the first successful example of fetal therapy. The use of this complex procedure, involving X-ray guided puncture of the fetal peritoneal cavity, was limited to fetuses with a gestational age ranging from 24 to 33 weeks. When performed below 26 weeks, survival rates were as low as 16%. The need for intrauterine transfusion was mainly based on determination of bilirubin levels in amniotic fluid, and plotting the results in a three-zone chart devised by Liley. This chart was based on correlations of amniotic fluid bilirubin concentrations with the degree of neonatal anaemia, and ranged from 27 to 41 weeks' gestation. In the 1980s, with the introduction of ultrasound-guided intravascular transfusion, treatment became possible from 17–18 weeks' gestation onwards. Consequently, there was a need for diagnostic tests to assess the degree of anaemia in the second trimester fetus. The use of the Liley chart was shown to be unreliable in the prediction of disease severity before 27 weeks' gestation. Ultrasonographic detection of fetal hydrops in these pregnancies reliably indicates severe anaemia, but for reasons that are still unclear, a significant number of severely anaemic fetuses do not show ultrasonographic signs of hydrops. In 1988, Nicolaides et al studied the use of several ultrasonographic parameters to predict anaemia in nonhydropic fetuses. Their results were disappointing, and they concluded that the only reliable diagnostic test to assess the degree of fetal disease was fetal blood sampling.

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Greimel, Patrick, Philipp Klaritsch, Holger Simonis, Bence Csapó, Maximilian Pohl, and Daniel Schneditz. "Amniodrainage-Induced Circulatory Dysfunction in Women Treated for Twin-To-Twin Transfusion Syndrome." Journal of Clinical Medicine 9, no. 7 (July 2, 2020): 2085. http://dx.doi.org/10.3390/jcm9072085.

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Twin-to-twin transfusion syndrome (TTTS) in monochorionic-diamniotic twin pregnancies usually requires fetoscopic laser ablation (FLA) followed by amniodrainage (AD). Perioperative maternal hemodynamic changes and hemodilution have been observed. Little is known about the underlying pathophysiology. We aimed to evaluate the impact of high volume amniodrainage on intrauterine pressure, placental thickness and maternal blood characteristics. A total of 18 cases of TTTS were included in this prospective pilot study. All patients were treated with FLA and subsequent AD. Intrauterine pressure and placental thickness were assessed before, during and after amniodrainage. Maternal hemoglobin, hematocrit and serum albumin were measured at admission and 24 h after the intervention. Amniodrainage led to a decrease in mean intrauterine pressure (from 30.1 ± 8.1 mmHg to 17.6 ± 3.6 mmHg (p < 0.001)) and an increase in mean placental thickness (from 16.8 ± 6.4 mm to 31.83 ± 8.64 mm (p < 0.001)). There was a positive correlation between changes in placental thickness and the amount of amniodrainage during intervention (Pearson’s Rho 0.73; p = 0.001). Hematocrit decreased from 33.4 ± 3.8 (%) to 28.4 ± 3.5 (%), i.e., an increase in relative blood volume by 18 ± 10.2% (p < 0.001). Albumin decreased from 37.9 ± 0.9 g/L to 30.7 ± 2.2 g/L, i.e., an increase in relative plasma volume by 24 ± 8.1% (p < 0.001). Amniodrainage leads to uterine decompression, increased placental thickness and subsequent maternal hemodilution. We propose the term “amniodrainage-induced circulatory dysfunction” for these specific maternal hemodynamic changes in the treatment of twin-to-twin transfusion syndrome.

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Lakhwani, S., P. Machado, P. Pecos, M. Coloma, S. Rebollo, and J. M. Raya. "Kell hemolytic disease of the fetus. Combination treatment with plasmapheresis and intrauterine blood transfusion." Transfusion and Apheresis Science 45, no. 1 (August 2011): 9–11. http://dx.doi.org/10.1016/j.transci.2011.06.014.

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JOHNSTONE‐AYLIFFE, CARINA, TOMAS PRIOR, CHARAS ONG, FIONA REGAN, and SAILESH KUMAR. "Early procedure‐related complications of fetal blood sampling and intrauterine transfusion for fetal anemia." Acta Obstetricia et Gynecologica Scandinavica 91, no. 4 (February 22, 2012): 458–62. http://dx.doi.org/10.1111/j.1600-0412.2011.01353.x.

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Şavkli, Ayşe Özge, Berna Aslan Çetin, Zuat Acar, Zeynep Özköse, Mustafa Behram, Sema Süzen Çaypinar, Ahmet Tayyar, and Mehmet Aytaç Yüksel. "Perinatal outcomes of intrauterine transfusion for foetal anaemia due to red blood cell alloimmunisation." Journal of Obstetrics and Gynaecology 40, no. 5 (August 29, 2019): 649–53. http://dx.doi.org/10.1080/01443615.2019.1647521.

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43

Van Mieghem, Tim, Liesbeth Lewi, Léonardo Gucciardo, Philip DeKoninck, Dominique Van Schoubroeck, Roland Devlieger, and Jan Deprest. "The Fetal Heart in Twin-to-Twin Transfusion Syndrome." International Journal of Pediatrics 2010 (2010): 1–8. http://dx.doi.org/10.1155/2010/379792.

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Twin-to-twin transfusion syndrome is a severe complication occurring in 10% of monochorionic twin pregnancies. The disease is usually explained as due to an intrauterine imbalance in intertwin blood exchange, which leads to a volume depleted-donor twin and an overfilled recipient twin. The recipient has signs of cardiac dysfunction, which can be measured using echocardiography or blood and amniotic fluid derived biomarkers. Whereas cardiac dysfunction typically progresses in pregnancies treated with amniodrainage, it usually disappears within a few weeks after fetoscopic laser coagulation of the connecting intertwin anastomoses. Nevertheless, recipients remain at a increased risk of pulmonary stenosis. In this paper, we summarize the cardiac alterations in twin-to-twin transfusion syndrome, describe the changes seen after fetal therapy, list the newly proposed staging systems based on fetal cardiac function, and make recommendations about the use of fetal echocardiography in the evaluation and followup of pregnancies complicated by twin-to-twin transfusion syndrome.

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Genova, L., F. Slaghekke, F. J. Klumper, J. M. Middeldorp, S. J. Steggerda, D. Oepkes, and E. Lopriore. "Management of Twin Anemia-Polycythemia Sequence Using Intrauterine Blood Transfusion for the Donor and Partial Exchange Transfusion for the Recipient." Fetal Diagnosis and Therapy 34, no. 2 (2013): 121–26. http://dx.doi.org/10.1159/000346413.

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Biskup, I., and W. Malinowski. "Twin-to-twin Transfusion Syndrome Type III - Case Report of an Intrauterine Death in Monochorionic Pregnancy." Acta geneticae medicae et gemellologiae: twin research 44, no. 1 (January 1995): 53–56. http://dx.doi.org/10.1017/s0001566000001896.

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AbstractThe acute form of twin-to-twin transfusion syndrome is caused by rapid transfer of blood from one of the twins to another via placental anastomoses. Usually, this only occurs during the second stage of labour as a result of a sudden relative rise of blood pressure in one of the fetal circulations. This can result in the sudden intrauterine death of a fetus (or both, as in our case). Currently, there is no reliable means of identifying such an at-risk pregnancy by means of ultrasound antenatally. We would classify this as TTTS Type III.

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Yalinkaya, Ahmet, Mehmet Sıddık Evsen, Yusuf Celik, Muhammet Erdal Sak, Hatice Ender Soydinc, and Mehmet Zeki Taner. "Intrauterine blood transfusion in immune hydrops fetalis, corrects middle cerebral artery Doppler velocimetry very quickly." Bosnian Journal of Basic Medical Sciences 12, no. 1 (February 20, 2012): 37. http://dx.doi.org/10.17305/bjbms.2012.2532.

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Bousquet, Frantz, Michel Segondy, Jean-Michel Faure, Françoise Deschamps, and Pierre Boulot. "B19 Parvovirus-Induced Fetal Hydrops:Good Outcome after Intrauterine Blood Transfusion at 18 Weeks of Gestation." Fetal Diagnosis and Therapy 15, no. 3 (2000): 132–33. http://dx.doi.org/10.1159/000020991.

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Yinon, Y., A. Shmueli, N. Duvdevani, B. Chayen, B. Weisz, and S. Lipitz. "OP15.06: Monochorionic twins complicated by twin anemia polycythemia sequence: perinatal outcome following intrauterine blood transfusion." Ultrasound in Obstetrics & Gynecology 52 (October 2018): 110. http://dx.doi.org/10.1002/uog.19529.

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Moise, Kenneth J., Giancarlo Mari, David J. Fisher, James C. Huhta, Lorraine E. Cano, and Robert J. Carpenter. "Acute fetal hemodynamic alterations after intrauterine transfusion for treatment of severe red blood cell alloimmunization." American Journal of Obstetrics and Gynecology 163, no. 3 (September 1990): 776–84. http://dx.doi.org/10.1016/0002-9378(90)91067-m.

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O'Riordan, Sarah L., Gillian Ryan, and Peter McParland. "432 To determine the rate of decline of fetal hemoglobin following an intrauterine blood transfusion." American Journal of Obstetrics and Gynecology 224, no. 2 (February 2021): S275—S276. http://dx.doi.org/10.1016/j.ajog.2020.12.453.

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Journal articles on the topic 'Blood transfusion intrauterine'

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