Roopali Donepudi, Jean-Marie Jouannic, Emeline Maisonneuve, Nicolas Sananes, Celine Muller, M A Sánchez-Durán, Francisca Molina, Pilar Carretero, Eugenia Antolin, Inmaculada Duyos, Isabella Fabietti, Asma Khalil, Conrado M Coutinho, Haleh Sangi-Haghpeykar, Magdalena Sanz Cortes
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Demographic, delivery, and postnatal variables were analyzed.</p><p><strong>Results: </strong>Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs. 15.8%, p = 0.7), prior pregnancy IUT (25.6 vs. 31.6%, p = 0.5) or neonatal transfusion (36.1 vs. 43.8%, p = 0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p = 0.03), lower starting hematocrit (13.3% [±6] vs. 17.7% [±8.2], p = 0.04), and trend toward lower gestational age (24.6 [20.1-27] vs. 26.4 [23.2-29.6] weeks, p = 0.08). No difference in birthweight, neonatal phototherapy, exchange, or simple transfusion was observed.</p><p><strong>Conclusion: </strong>This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops, and lower starting hematocrit was seen. Neither technique affected outcomes. 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引用次数: 0
摘要
引言:宫内输血(IUT)治疗溶血性疾病引起的胎儿贫血可通过腹膜内、心内和血管内输血(IVT)进行。我们研究的目的是比较不同的输血技术。方法:回顾性分析2012-2020年8个国际中心红细胞同种异体免疫继发宫内节育器的情况。大脑中动脉峰值收缩速度疑似严重贫血 1.5月。对人口统计学、分娩和产后变量进行了分析。结果:共纳入344例手术、325例IVT和19例其他技术(非IVT)。在人口统计学、死产史(20.5 vs 15.8%,p=0.7)、妊娠前宫内节育器(25.6 vs 31.6%,p=0.5)或新生儿输血史(36.1 vs 43.8%,p=0.5%)方面没有差异。第一次宫内节育器时,非IVT有更高的积水(42.1%vs 20.4%,p=0.03)、更低的起始红细胞压积(13.3%(±6)vs 17.7%(±8.2),p=0.04)和更低的胎龄趋势(24.6(20.1-27)vs 26.4(23.2-29.6)周,p=0.08)。在出生体重、新生儿光疗、交换或简单输血方面没有差异。结论:这是比较治疗胎儿贫血技术的最大研究之一。IVT是最常见的,其他技术更有可能在积水中进行,并且可以看到较低的起始红细胞压积。这两种技术都不影响结果。这项研究可能表明,医生的经验可能是影响结果的最大因素。
Fetal Anemia: Determinants and Perinatal Outcomes according to the Method of Intrauterine Blood Transfusion.
Introduction: Fetal anemia from hemolytic disease treated by intrauterine transfusion (IUT) can be performed by intraperitoneal, intracardiac, and intravascular transfusion (IVT). Objective of our study was to compare different transfusion techniques.
Methods: Retrospective review of IUT secondary to red cell alloimmunization was conducted at eight international centers from 2012 to 2020. Severe anemia suspected if middle cerebral artery peaks systolic velocity ≥1.5 multiples of the median. Demographic, delivery, and postnatal variables were analyzed.
Results: Total of 344 procedures, 325 IVT and 19 other techniques (non-IVT) included. No difference in demographics, history of stillbirth (20.5 vs. 15.8%, p = 0.7), prior pregnancy IUT (25.6 vs. 31.6%, p = 0.5) or neonatal transfusion (36.1 vs. 43.8%, p = 0.5). At first IUT, non-IVT had higher hydrops (42.1% vs. 20.4%, p = 0.03), lower starting hematocrit (13.3% [±6] vs. 17.7% [±8.2], p = 0.04), and trend toward lower gestational age (24.6 [20.1-27] vs. 26.4 [23.2-29.6] weeks, p = 0.08). No difference in birthweight, neonatal phototherapy, exchange, or simple transfusion was observed.
Conclusion: This is one of the largest studies comparing techniques to treat fetal anemia. IVT was most performed, other techniques were more likely performed in hydrops, and lower starting hematocrit was seen. Neither technique affected outcomes. This study may suggest that physician's experience may be the strongest contributor of outcomes.
期刊介绍:
The first journal to focus on the fetus as a patient, ''Fetal Diagnosis and Therapy'' provides a wide range of biomedical specialists with a single source of reports encompassing the common discipline of fetal medicine.