title: Outcome for children treated with fetal intravascular transfusions because of severe blood group antagonism.
abstract: OBJECTIVE
  To describe the outcome for 92 fetuses treated between May 1987 and January of 1993 with intrauterine (intravascular) transfusions for severe hemolytic disease in comparison with a high-risk and a healthy control group.
  
  
  METHODS
  Information on the perinatal period was obtained from the patient records. The children regularly attended the outpatient clinic, and a general pediatric examination was performed on each visit. The psychometer development of the child until age 4 1/2 years was assessed according to Gesell. At the age of 5 years, the adaptation part of the Denver Developmental Screening Test and a Dutch-language test were used. A neurologic examination was performed according to Touwen.
  
  
  RESULTS
  In our study, 77 (83.7%) of 92 fetuses were born alive after intravascular transfusions. The overall survival rate was 79.3%. The follow-up group included 69 infants, with an age range of 6 months to 6 years. Correlation between antenatal and perinatal features showed a significant negative relationship between the number of intrauterine transfusions and the duration of phototherapy (p = 0.002). The probability that neurologic abnormalities would occur was significantly greater when perinatal asphyxia had been present (p < 0.05) and with a lower cord hemoglobin level at birth (p = 0.03). The total number of children with disabilities was 10.1% (7/69).
  
  
  CONCLUSIONS
  The neurodevelopmental outcome for the group of survivors compared favorably with a group of high-risk, very low birth weight infants (10.1% to 18%), and less favorably with a healthy control group (10.1% to 6%).
authors.affiliation: Department of Pediatrics, University Hospital Leiden, The Netherlands.
authors.forename: H M
authors.initials: HM
authors.lastname: Janssens
authors.forename: M J
authors.initials: MJ
authors.lastname: de Haan
authors.forename: I L
authors.initials: IL
authors.lastname: van Kamp
authors.forename: R
authors.initials: R
authors.lastname: Brand
authors.forename: H H
authors.initials: HH
authors.lastname: Kanhai
authors.forename: S
authors.initials: S
authors.lastname: Veen
mesh_terms: D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects / Q000379:methods*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002658:Developmental Disabilities / Q000209:etiology*; D004899:Erythroblastosis, Fetal / Q000209:etiology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D010789:Phototherapy; D011379:Prognosis; D012203:Rh Isoimmunization / Q000150:complications; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome