[Feto-maternal immunization and fetal hemolytic disease: invasive diagnostics and therapy in the Warsaw center of serological collision in years 1992-1999].
OBJECTIVE
The objective of this study was the assessment of intrauterine procedures, which are performed during the diagnostic phase and therapy of fetal hemolytic disease in the Warsaw Center of Serological Collision.


METHODS
The study covered 146 women, who were patients of the Center from 1992 to 1999. Analyzed were the time of commencement of diagnostic and treatment, type of operations, duration of therapy, time and manner of delivery after the past intrauterine procedures, the medical condition of infants born as a result of these deliveries and the necessity for blood treatment in the early neonatal stage.


RESULTS
451 intrauterine procedures were carried out, of which 159 were diagnostic punctures of the umbilical vessel and 292 were fetal transfusions. The diagnostics and treatment was performed between the 19 and 38 week of pregnancy. The number of punctures for each patient ranged from 1 to 4, and 1 to 10 for intrauterine transfusions. The therapy, which on average lasted 42 days, significantly improved the fetal blood morphology results. During the therapy 5 intrauterine demises were noted--3 as a result of advanced fetal hemolytic disease and 2 related to operation complications. The average pregnancy duration in the analyzed group was 36.4 for treated women and 37.4 weeks for diagnosed women. 52.7% of deliveries were vaginal, 47.3% were performed by cesarean section. The general condition of 87% of infants was good. However, 77% of infants required blood treatment during the early neonatal period.


CONCLUSIONS
Invasive methods of fetal hemolytic disease diagnostics and intrauterine therapy assure high efficiency in the guiding of serological collision and fetal hemolytic disease conflicted pregnancies. At the same time, these methods are safe and carry a low risk of complications.
Wielgoś
M
M
I Katedry i Kliniki Połoznictwa i Ginekologii AM w Warszawie.
Rokicki
T
T
Wiczyńska-Zajac
A
A
Grodzka
M
M
Moneta
J
J
Marianowski
L
L
D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D001803:Blood Transfusion / Q000379:methods; D005260:Female; D005315:Fetal Diseases / Q000175:diagnosis / Q000276:immunology* / Q000628:therapy*; D006801:Humans; D011044:Poland; D011247:Pregnancy; D011248:Pregnancy Complications; D011296:Prenatal Diagnosis; D012203:Rh Isoimmunization / Q000276:immunology*