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Intrauterine transfusion in fetuses affected by severe perinatal hemolytic disease: a descriptive study

Objective: to report 54 intrauterine intravascular transfusions (IITs), describing procedure related complications and associated perinatal morbidity and mortality. Methods: fetuses undergoing IITs at Clínica Materno-Fetal and Maternidade Carmela Dutra, Florianópolis, SC, between January 1992 and August 1997 were included in the study. Patients demographics, procedure and newborn related data were tabulated for analysis and presented in descriptive form, using percentage, mean, standard deviation, median, range and relative risk (RR) with 95% confidence interval as appropriate. Results: fifty IITs and four exchange transfusions were performed in twenty-one fetuses. There were four deaths (20%), three of which occurred (75%) in hydropic fetuses. Mean gestational age at the time of the first IIT was 29.1 weeks, the mean hemoglobin concentration was 7.1 mg/dl and the mean rise in hemoglobin level per procedure was 5.69 mg/dl. Procedure related mortality rate was 7.4%. Mean gestational age at birth was 33.9 weeks and mean birth weight was 2,437 grams. Sixty-five percent of the newborns received complementary exchange transfusions. Conclusion: the procedure related mortality rate was 7.4%, similar to the mortality rate reported in the world literature. The perinatal mortality rate (20%) was higher than that reported in other countries but lower than the perinatal mortality rate reported in a study conducted in Brazil, with a similar prevalence of hydropic fetuses.

Intrauterine transfusion; Hemolytic disease; Cordocentesis; Fetal blood sampling; Isoimmunization


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