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Complications of intravascular intrauterine transfusion for Rh alloimmunization
BACKGROUND: Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities. OBJECTIVE: Review the outcomes of Rh alloimmunization, including indications and possible complications. DESIGN: Retrospective cohort (medical record review)....
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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King Faisal Specialist Hospital and Research Centre
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650595/ https://www.ncbi.nlm.nih.gov/pubmed/34873935 http://dx.doi.org/10.5144/0256-4947.2021.313 |
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author | Alkhaibary, Asma Ali, Mohannad Tulbah, Maha Al-Nemer, Maha Khan, Rubina M. Al Mugbel, Maisoon Al Sahan, Nada Hassounah, Marwah Mazen Alshammari, Waleed Kurdi, Wesam I. |
author_facet | Alkhaibary, Asma Ali, Mohannad Tulbah, Maha Al-Nemer, Maha Khan, Rubina M. Al Mugbel, Maisoon Al Sahan, Nada Hassounah, Marwah Mazen Alshammari, Waleed Kurdi, Wesam I. |
author_sort | Alkhaibary, Asma |
collection | PubMed |
description | BACKGROUND: Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities. OBJECTIVE: Review the outcomes of Rh alloimmunization, including indications and possible complications. DESIGN: Retrospective cohort (medical record review). SETTING: Tertiary care center. PATIENTS AND METHODS: We retrieved the records for all mothers who had an IUT for Rh alloimmunization between January 2009 and August 2019. We collected data on complications, post-transfusion hemoglobin and antibody combinations. MAIN OUTCOME MEASURE: Complications of IUT. SAMPLE SIZE: 119 mothers with 154 fetuses (154 different pregnancies). RESULTS: The 154 fetuses had 560 intrauterine transfusions. The median pre-IUT hemoglobin was a median of 8.0 g/dL while the median post-IUT hemoglobin 16 g/dL. Immediate procedure-related complications included fetal bradycardia in 2.7%, significant bleeding from the cord puncture site (for more than 2 minutes in 0.9%), and contractions in 0.9%. Eight (5.2%) were delivered by cesarean delivery due to IUT-specific complications such as post-procedure fetal bradycardia. Intrauterine fetal death complicated 8.4% of the pregnancies (13 fetuses). Phototherapy was required in 76 (49.4%), postnatal blood transfusions in 17 (11%), and exchange transfusion in 11 (7.1%). Neonatal death occurred 8 (5.2%). Data were insufficient to assess associations of complications with antibody combinations. CONCLUSIONS: Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization). LIMITATIONS: Case series. CONFLICT OF INTEREST: None. |
format | Online Article Text |
id | pubmed-8650595 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | King Faisal Specialist Hospital and Research Centre |
record_format | MEDLINE/PubMed |
spelling | pubmed-86505952021-12-21 Complications of intravascular intrauterine transfusion for Rh alloimmunization Alkhaibary, Asma Ali, Mohannad Tulbah, Maha Al-Nemer, Maha Khan, Rubina M. Al Mugbel, Maisoon Al Sahan, Nada Hassounah, Marwah Mazen Alshammari, Waleed Kurdi, Wesam I. Ann Saudi Med Original Article BACKGROUND: Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities. OBJECTIVE: Review the outcomes of Rh alloimmunization, including indications and possible complications. DESIGN: Retrospective cohort (medical record review). SETTING: Tertiary care center. PATIENTS AND METHODS: We retrieved the records for all mothers who had an IUT for Rh alloimmunization between January 2009 and August 2019. We collected data on complications, post-transfusion hemoglobin and antibody combinations. MAIN OUTCOME MEASURE: Complications of IUT. SAMPLE SIZE: 119 mothers with 154 fetuses (154 different pregnancies). RESULTS: The 154 fetuses had 560 intrauterine transfusions. The median pre-IUT hemoglobin was a median of 8.0 g/dL while the median post-IUT hemoglobin 16 g/dL. Immediate procedure-related complications included fetal bradycardia in 2.7%, significant bleeding from the cord puncture site (for more than 2 minutes in 0.9%), and contractions in 0.9%. Eight (5.2%) were delivered by cesarean delivery due to IUT-specific complications such as post-procedure fetal bradycardia. Intrauterine fetal death complicated 8.4% of the pregnancies (13 fetuses). Phototherapy was required in 76 (49.4%), postnatal blood transfusions in 17 (11%), and exchange transfusion in 11 (7.1%). Neonatal death occurred 8 (5.2%). Data were insufficient to assess associations of complications with antibody combinations. CONCLUSIONS: Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization). LIMITATIONS: Case series. CONFLICT OF INTEREST: None. King Faisal Specialist Hospital and Research Centre 2021-11 2021-12-02 /pmc/articles/PMC8650595/ /pubmed/34873935 http://dx.doi.org/10.5144/0256-4947.2021.313 Text en Copyright © 2021, Annals of Saudi Medicine, Saudi Arabia https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND). The details of which can be accessed at http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Original Article Alkhaibary, Asma Ali, Mohannad Tulbah, Maha Al-Nemer, Maha Khan, Rubina M. Al Mugbel, Maisoon Al Sahan, Nada Hassounah, Marwah Mazen Alshammari, Waleed Kurdi, Wesam I. Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title | Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title_full | Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title_fullStr | Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title_full_unstemmed | Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title_short | Complications of intravascular intrauterine transfusion for Rh alloimmunization |
title_sort | complications of intravascular intrauterine transfusion for rh alloimmunization |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8650595/ https://www.ncbi.nlm.nih.gov/pubmed/34873935 http://dx.doi.org/10.5144/0256-4947.2021.313 |
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