Asma Alkhaibary, Mohannad Ali, Maha Tulbah, Maha Al-Nemer, Rubina M Khan, Maisoon Al Mugbel, Nada Al Sahan, Marwah Mazen Hassounah, Waleed Alshammari, Wesam I Kurdi
{"title":"Rh同种异体免疫的宫内血管内输血并发症。","authors":"Asma Alkhaibary, Mohannad Ali, Maha Tulbah, Maha Al-Nemer, Rubina M Khan, Maisoon Al Mugbel, Nada Al Sahan, Marwah Mazen Hassounah, Waleed Alshammari, Wesam I Kurdi","doi":"10.5144/0256-4947.2021.313","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities.</p><p><strong>Objective: </strong>Review the outcomes of Rh alloimmunization, including indications and possible complications.</p><p><strong>Design: </strong>Retrospective cohort (medical record review).</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Main outcome measure: </strong>Complications of IUT.</p><p><strong>Sample size: </strong>119 mothers with 154 fetuses (154 different pregnancies).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization).</p><p><strong>Limitations: </strong>Case series.</p><p><strong>Conflict of interest: </strong>None.</p>","PeriodicalId":8016,"journal":{"name":"Annals of Saudi Medicine","volume":"41 6","pages":"313-317"},"PeriodicalIF":1.5000,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/ee/0256-4947.2021.313.PMC8650595.pdf","citationCount":"1","resultStr":"{\"title\":\"Complications of intravascular intrauterine transfusion for Rh alloimmunization.\",\"authors\":\"Asma Alkhaibary, Mohannad Ali, Maha Tulbah, Maha Al-Nemer, Rubina M Khan, Maisoon Al Mugbel, Nada Al Sahan, Marwah Mazen Hassounah, Waleed Alshammari, Wesam I Kurdi\",\"doi\":\"10.5144/0256-4947.2021.313\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Intravascular intrauterine transfusion (IUT) is considered a safe procedure, but complications still occur, including fatalities.</p><p><strong>Objective: </strong>Review the outcomes of Rh alloimmunization, including indications and possible complications.</p><p><strong>Design: </strong>Retrospective cohort (medical record review).</p><p><strong>Setting: </strong>Tertiary care center.</p><p><strong>Patients and methods: </strong>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.</p><p><strong>Main outcome measure: </strong>Complications of IUT.</p><p><strong>Sample size: </strong>119 mothers with 154 fetuses (154 different pregnancies).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>Intrauterine transfusion is an effective treatment with high survival rates (around 90% for cases of Rh alloimmunization).</p><p><strong>Limitations: </strong>Case series.</p><p><strong>Conflict of interest: </strong>None.</p>\",\"PeriodicalId\":8016,\"journal\":{\"name\":\"Annals of Saudi Medicine\",\"volume\":\"41 6\",\"pages\":\"313-317\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2021-11-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8d/ee/0256-4947.2021.313.PMC8650595.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Annals of Saudi Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5144/0256-4947.2021.313\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2021/12/2 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Saudi Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5144/0256-4947.2021.313","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2021/12/2 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
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).
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).
期刊介绍：
The Annals of Saudi Medicine (ASM) is published bimonthly by King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. We publish scientific reports of clinical interest in English. All submissions are subject to peer review by the editorial board and by reviewers in appropriate specialties. The journal will consider for publication manuscripts from any part of the world, but particularly reports that would be of interest to readers in the Middle East or other parts of Asia and Africa. Please go to the Author Resource Center for additional information.
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