Intrauterine fetal blood transfusion: At which circumstances, when and how often should be performed a current review of the literature Intrauterin Fetal Kan Transfüzyonu: Hangi Durumlarda, Ne Zaman ve Ne Sklkta Yaplmal Literatürün Güncel Bir Derlemesi
Turkiye Klinikleri Jinekoloji Obstetrik, cilt.23, sa.3, ss.186-192, 2013 (Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 23 Sayı: 3
- Basım Tarihi: 2013
- Dergi Adı: Turkiye Klinikleri Jinekoloji Obstetrik
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.186-192
- Anahtar Kelimeler: Blood transfusion, Fetal therapies, Intrauterine
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Although increasing utilization of anti-D immunglobulin recently, we encounter fetal anemia secondary to Rh alloimmunisation. Other most common reasons of fetal anemia are maternal parvovirus infection, chronic fetomaternal bleeding, eritrocyte function disorders and twin to twin transfusion syndrome. Intrauterine transfusion is mandatory when fetal hematocrit level falls below 30%. Intrauterine transfusion, that can be performed between 18 and 35 weeks of gestation, is utilized via intravasculary, intraperitoneally and combined fashions. Repeated transfusions are needed by 10-14 days from the initial transfusion because the hematocrit level of the transfused blood falls by 1% daily. However, the multiple of median value of middle cerebral artery of the fetus is worthy to establish the diagnosis of fetal anemia, current data is insufficient for recommendation of the measurement of multiple of median value of middle cerebral artery to decide the timing of the subsequent transfusion. Besides the overall complication rate is 3.1% and the overall survival rate is 89% following intrauterine transfusion, pregnancy outcomes of fetal anemia treatment vastly depends on the gestational age upon establishment of fetal anemia diagnosis, the medical center that hosts transfusion process, personel experience of the clinician and presence of fetal hydrops at admission. Seventy percent of the fetuses with fetal hydrops and 92% of the ones without fetal hydrops survive following intrauterine transfusion. Therefore, before the establishment of fetal hydrops, among fetuses suspected to have anemia, it is of paramount importance to perform a percutaneous umbilical blood sampling and a concurrent intrauterine transfusion procedure when needed. Copyright © 2013 by Türkiye Klinikleri.