Postnatal Outcomes of Intrauterine Transfusion Infants Due to Immun-Hemolytic Disease

Authors : Fatma Hilal YILMAZ

Pages : 348-351

View : 19 | Download : 9

Publication Date : 2019-12-10

Article Type : Conference Paper

Abstract :Immune-hemolytic disease of fetus and newborn is the clinical picture where maternal specific IgG autoantibodies passing through placenta bind to erythrocytes and result in progressive fetal hemolysis. This hemolysis can lead to fetal anemia. In severe cases, can cause hydrops fetalis and intrauterine death. The use of Rh immune globulin to prevent susceptibility of Rhesus insert ignore into journalissuearticles values(Rh); negative pregnant women has reduced the immune-hemolytic disease of the fetus to 1 / 300-1 / 600 live births insert ignore into journalissuearticles values(1);. Despite advances in the use of Rhesus immunoglobulin prophylaxis, perinatal mortality remains approximately 1% in high resource countries and as high as 14% in low resource countries insert ignore into journalissuearticles values(2,3);. These outcomes are preventable with fetal blood sampling and intrauterine transfusion insert ignore into journalissuearticles values(IUT);, which have greatly im- proved survival in affected pregnancies, including those with fetal hydrops, and those with an onset < 22 weeks’ gestational age. The aim of this study was to evaluate the postnatal outcomes of newborns who received transfusion in the intrauterine period due to immun-hemolytic disease. Method: This study was performed retrospectively between March 2018 and July 2019. Infants who underwent erythrocyte transfusion during the intrauterine period with the diagnosis of immune-hemolytic disease and followed in the neonatal intensive care unit were included. Demographic data of the patients, APGAR scores at 1 and 5 minutes, prenatal erythrocyte transfusion, exchange transfusion and postnatal erythrocyte transfusion requirement, birth hemoglobin and bilirubin levels and reticulocyte count, highest bilirubin level, intrauterine transfusion number, duration of phototherapy, hydrops status, discharge status duration and mortality rate were recorded. Data analysis and report writing operations were performed on computer. Median insert ignore into journalissuearticles values(min-max);, frequency distributions and percentages were used to summarize the data. Mann-Whitney U test was used for comparisons between the groups and p <0.05 was accepted for statistical significance. Results: A total of 16 infants were included in the study. The median gestational week was 34 insert ignore into journalissuearticles values(28-37); and the median birth weight was 2395 insert ignore into journalissuearticles values(1420-2985); grams. Nine insert ignore into journalissuearticles values(56.25%); of the babies were female and 7 insert ignore into journalissuearticles values(43.75%); were male. All were born by cesarean section. The median Apgar 1st and 5th minute scores were 5 insert ignore into journalissuearticles values(0-6); and 6 insert ignore into journalissuearticles values(3-10);, respectively. The median hemoglobin median was 8 insert ignore into journalissuearticles values(4-18);, reticulocyte count 8.5 insert ignore into journalissuearticles values(0-52);, the highest bilurubin level median was 10 insert ignore into journalissuearticles values(4-20); and median phototherapy time was 4.5 insert ignore into journalissuearticles values(1-6); days. Ten patients had 3 or less intrauterine transfusions and 6 patients had more than 3 intrauterine transfusions. Exchange transfusion was performed a maximum of 2 times in 10 insert ignore into journalissuearticles values(62.5%); infants. Postnatal erythrocyte transfusion was performed to 6 insert ignore into journalissuearticles values(37.5%); infants due to anemia during the period until discharge. 10 insert ignore into journalissuearticles values(62.5%); of the infants had hydrops findings. The median discharge time was 19 insert ignore into journalissuearticles values(1-78); days. A total of 2 infants insert ignore into journalissuearticles values(12.5%); died insert ignore into journalissuearticles values(Table-1);.
Keywords : Postnatal Outcomes