Neonatal outcome after fetal anemia managed by intrauterine transfusion

被引:17
|
作者
Garabedian, C. [1 ]
Rakza, T. [1 ]
Thomas, D. [1 ]
Wibaut, B. [2 ]
Vaast, P. [1 ]
Subtil, D. [1 ,3 ]
Houfflin-Debarge, V. [1 ,3 ]
机构
[1] Reg Univ Hosp Ctr CHRU Lille, Jeanne de Flandre Hosp, Dept Obstet, Lille, France
[2] CHRU Lille, Jeanne de Flandre Hosp, Inst Hematol & Transfus, F-59037 Lille, France
[3] Univ Lille North France, Lille, France
关键词
Anemia; Hyperbilirubinemia; Intrauterine transfusion; Pediatric outcome; Rhesus hemolytic disease; EXCHANGE-TRANSFUSION; CELL ALLOIMMUNIZATION; HEMOLYTIC-DISEASE; PREVENTION; DIAGNOSIS; INFANTS;
D O I
10.1007/s00431-015-2573-x
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
In-utero transfusion is now well under control and improves the survival of foetuses monitored for fetal anemia with a survival rate of more than 80 %. The aim was to evaluate short-term neonatal outcome after fetal severe anemia managed by intrauterine transfusions. We did a retrospective study of all neonates born after management of severe fetal anemia (n = 93) between January 1999 and January 2013 in our regional center. The two main causes of anemia were maternal red blood cell alloimmunization (N = 81, 87 %) and Parvovirus B19 infection (N = 10, 10.8 %). In the alloimmunization group, phototherapy was implemented in 85.2 % of cases with a maximum level of bilirubin of 114.4 +/- 60.7 (mg/dl). Transfusion and exchange transfusion were, respectively, required in 51.9 % and in 34.6 % of cases. One neonate presented a convulsive episode, and we observed three neonatal deaths. In the parvovirus group, none of the child had anemia at birth and no management was necessary. Conclusion: Contemporary management of Rhesus disease is associated with encouraging neonatal outcomes. In case of Parvovirus infection, no specific management is necessary at. But, in all cases of fetal anemia, children should be followed up with particular attention to neurologic development.
引用
收藏
页码:1535 / 1539
页数:5
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