The usefulness of Doppler ultrasonography and the perinatal outcome of fetal anemia treated with intraumbilical venous transfusion.
10.5468/kjog.2010.53.4.303
- Author:
Su Jin BAEK
1
;
Hye Sung WON
;
Jae Yoon SHIM
;
Pil Ryang LEE
;
Ahm KIM
Author Information
1. Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. hswon@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Fetal anemia;
Hydrops fetalis;
Fetal transfusion
- MeSH:
Anemia;
Blood Transfusion, Intrauterine;
Cordocentesis;
Counseling;
Fetal Hemoglobin;
Fetus;
Gestational Age;
Hemoglobins;
Humans;
Hydrops Fetalis;
Infant, Newborn;
Korea;
Middle Cerebral Artery;
Parents;
Ultrasonography, Doppler
- From:Korean Journal of Obstetrics and Gynecology
2010;53(4):303-312
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: We undertook this study to determine the clinical characteristics and the prognostic factors of neonatal survival in patients with fetal anemia who were treated by intraumbilical venous transfusion (IUT). METHODS: From July 2000 to March 2009, 16 cases of fetal anemia were diagnosed at Asan Medical Center in Seoul, Korea. These patients underwent intraumbilical venous transfusions and were thus included in our study. Doppler measurement of the middle cerebral artery peak systolic velocity was performed before and after cordocentesis in all fetuses. RESULTS: The gestational age at the time of the diagnosis of anemia ranged from 21.3 to 33.6 weeks. There was a linear correlation between pre- and post-procedure fetal hemoglobin (Hb,MoM, (x)) and the MCA-PSV (MoM, (y)), i.e., y=0.810-0.229x, r2=0.542, CI 0.316-0.141, p<0.005; and y=1.374-0.391x, r2=0.499, CI 0.584-0.197, p<0.005. The survival was better in patients with severe anemia than those with mild to moderate anemia (p<0.05), and survival was better in patients with anemia of a known cause than those with anemia of an unknown cause (p<0.001). CONCLUSION: In fetuses with anemia, the severity of the anemia before IUT and the change of hemoglobin concentration after IUT, can be estimated noninvasively using Doppler ultrasonography, on the basis of an increase in the peak velocity of systolic blood flow in the middle cerebral artery. Both severity and etiology were meaningful factors for the survival of neonates with fetal anemia who were treated by intraumbilical venous transfusion. Although fetuses have severe anemia, they expected improved survival through IUT. These data are valuable information for use when counseling the parents of an affected fetus.
