Nationwide survey of intrauterine blood transfusion for fetal anemia in Japan

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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Fetal ascites caused by intraabdominal bleeding and secondary fetal anaemia treated by intrauterine blood transfusion (IUT) in the gestional age of 28 weeks

Ultraschall in der Medizin - European Journal of Ultrasound ◽

10.1055/s-0036-1587948 ◽

2016 ◽

Vol 37 (S 01) ◽

Author(s):

C Voigt ◽

U Schneider ◽

G Seliger ◽

H Proquitte ◽

M Tchirikov ◽

...

Keyword(s):

Blood Transfusion ◽

Intraabdominal Bleeding ◽

Intrauterine Blood Transfusion

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A rare case of intra-uterine blood transfusion for fetal anemia caused by a giant placental chorioangioma

Case Reports in Perinatal Medicine ◽

10.1515/crpm-2019-0020 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Shira Raviv ◽

Alon Shrim ◽

Julia Eidel ◽

Yoav Yinon ◽

Boaz Weiz ◽

...

Keyword(s):

Blood Transfusion ◽

Peak Systolic Velocity ◽

Fetal Hemoglobin ◽

Vascular Lesion ◽

Hemoglobin Level ◽

Fetal Anemia ◽

Fetal Heart Rate Monitoring ◽

Fetal Complications ◽

Tumor Like Lesions ◽

Fetal Hemoglobin Level

Abstract Objectives Chorioangiomas (CAs) are the most frequent tumor-like-lesions of the placenta. Giant CAs (more than 4–5 cm in diameter) is rare and may result in severe maternal fetal complications. Case presentation A 38-year-old multigravida presented at 31 weeks’ gestation with contractions. Upon evaluation, contractions were spontaneously ceased, and the cervix was closed. Ultrasound examination revealed a single viable fetus, polyhydramnios and a 75 x 48 x 82 mm vascular lesion located on the placental surface near the cord insertion. Doppler assessment was suggestive of fetal anemia with middle cerebral artery-peak systolic velocity (MCA-PSV) 1.8 MoM’s. Fetal heart rate monitoring and biophysical scores were reassuring. Following betamethasone fetal cord sampling that revealed fetal hemoglobin level of 8.8 g/dL, 57 cc of blood was transfused resulting in final hemoglobin level of 14.3 g/dL measured prior to needle extraction. MCA-PSV was normalized immediately after the procedure, however aggravated at the following day with MCA-PSV 65 cm/s (1.46 MoM’s). No other intervention was taken and MCA-PSV continued to fluctuate from slight to severe anemia spontaneously over a period of two weeks. At 34 gestational weeks, the women delivered a healthy baby. Fetal hemoglobin level at delivery was 21 g/dL. Conclusions Fetal blood transfusion is a reasonable treatment for fetal anemia in cases of giant chorioangiomas. Following transfusion, MCA-PSV may act unexpectedly reflecting various mechanisms affecting the flow.

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