title: Intra-uterine exchange transfusion under ultrasound guidance.
abstract: Thirty intra-uterine exchange transfusions (I.U.E.T.) under ultrasound guidance were performed on 15 pregnancies in 14 severely Rh-sensitized women. Our technique and a new method of catheterization of the umbilical cord are described. I.U.E.T. were commenced at 19-34 gestational weeks and repeated up to 5 times at 15 to 60 days intervals. The lowest pretransfusion fetal hemoglobin was 3 milligrams at 25 weeks. All the hydrops (4 cases) reversed a few days after the first procedure. The survival rate is 50% for hydropic fetuses and 66.6% for all cases. This technique avoids fetal hypervolemia and also too repetitive procedures by quick renewal of red cells. Catheterization offers a simple and safe access to the umbilical vein even with important fetal movements.
authors.affiliation: Service Gynecologie Obstétrique I, Maternité de l'Hotel Dieu, Université Clermont-Ferrand I, France.
authors.forename: D
authors.initials: D
authors.lastname: Lemery
authors.forename: M F
authors.initials: MF
authors.lastname: Urbain
authors.forename: P
authors.initials: P
authors.lastname: Van Lieferinghen
authors.forename: J C
authors.initials: JC
authors.lastname: Micorek
authors.forename: B
authors.initials: B
authors.lastname: Jacquetin
mesh_terms: D001805:Blood Transfusion, Intrauterine / Q000379:methods*; D001810:Blood Volume; D002404:Catheterization / Q000379:methods; D004899:Erythroblastosis, Fetal / Q000097:blood / Q000628:therapy*; D005078:Exchange Transfusion, Whole Blood / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System; D014463:Ultrasonography; D014471:Umbilical Veins
chemical_list: D012204:Rh-Hr Blood-Group System