Volume 24, Issue 101, January - February, 2020

Neonatal Outcomes of Rh Alloimmunization Pregnancy Treated with Intrauterine Transfusion

Shirin Niroomanesh¹, Salmeh Dadgar^2♦, Mahboobeh Shirazi³, Fatemeh Rahimi Sharbaf⁴, Fatemeh Golshahi⁵

¹Perinatologist, Maternal, Fetal and Neonatal Research Center, Moheb Yas Women General Hospital, Tehran University of Medical Sciences, Tehran, Iran
²Perinatologist, Department of Obstetrics and Gynecology, Emam reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
³Perinatologist, Maternal, Fetal and Neonatal Research Center, Moheb Yas Women General Hospital, Tehran University of Medical Sciences, Tehran, Iran
⁴Perinatologist, Maternal, Fetal and Neonatal Research Center, Moheb Yas Women General Hospital, Tehran University of Medical Sciences, Tehran, Iran
⁵Perinatologist, Maternal, Fetal and Neonatal Research Center, Moheb Yas Women General Hospital, Tehran University of Medical Sciences, Tehran, Iran

^♦Corresponding author
Department of Obstetrics and Gynecology, Emam reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Email: dadgars@mums.ac.ir

ABSTRACT

Introduction: Fetal anemia is a major problem and cause of neonatal morbidities and mortalities. Maternal Rh allo-immunization has not been eliminated with subsequent erythroblastosis fetalis and hemolytic disease still occasionally occurring. In this study, we evaluated the neonatal outcomes of intra-uterine transfusion (IUT)-treated pregnancies because Rh allo-immunization and fetal anemia. Patients and Methods: This was a prospective cohort study in which we evaluated pregnancies between 17-35 week gestational ages in Rhesus negative mothers who referred to perinatology clinic because of fetal anemia, Tehran University of Medical Sciences during May 2016 to April 2018 in Yas Hospital. Anemia was confirmed by Doppler ultrasonography. For all patients, intra-uterine transfusion was performed based on gestational age. Demographic, clinical and para-clinical variables were measured in each case and each time of IUT. Results: There were 33 Rh iso-immunized pregnancies; of which 6 fetuses were hydropic and remaining 27 were non-hydropic. IUT was perfumed 86 times in these cases. The mean of mother age was 31.24± 6.06 years old. The mean hemoglobin after birth was 7.92± 2.65 g/dL. The mean of transfused blood in all cases was 92.73± 45.14 cc. The survival rate in our study was 75.8% and eight fetuses were died (24.2%). There were significant difference between ACA PSV (P=0.012) and MCA PSV (P=0.015) with neonatal outcome (mortality or survival) in our study. Conclusion: In our investigation, IUT was shown to be lifesaving and very effective in the management of Rh immunized pregnancies. The results were comparable with other evaluations with high survival rate. We also showed that both ACA PSV and PCA PSV have a same value in diagnosis of fetal anemia. MCA PSV and ACA PSV can significantly predict the mortality of fetus after IUT.

Keywords: Rh immunization, Intra-uterine transfusion, fetal Doppler sonography

Medical Science, 2020, 24(101), 57-65

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