title: Intravenous fetal exchange transfusion before 22 weeks of gestation in early and severe red-cell fetomaternal alloimmunization.
abstract: OBJECTIVE
  To determine the perinatal outcome in severe red-cell fetomaternal alloimmunization.
  
  
  METHODS
  Retrospective series of 32 affected fetuses treated with intravenous fetal exchange transfusion (IFET) before 22 weeks of gestation. The main outcome measures were the degree of fetal anemia, fetal transfusions and perinatal outcome.
  
  
  RESULTS
  The first IFET was performed at 19.8 +/- 1.8 weeks of gestation. All fetuses were severely anemic and hemoglobin levels were not different between 20 hydropic and 12 nonhydropic fetuses (4.1 +/- 2.5 vs. 5.6 +/- 2.8 g/dl, p=0.33). The initial maternal anti-D level ranged from 4 to 76 microg/l and was not correlated to fetal anemia (r=-0.07).
  
  
  CONCLUSIONS
  The overall perinatal survival rate was 78% compared to a previous perinatal loss rate excluding first pregnancies of 55.5%.
authors.affiliation: Service de Gynécologie-Obstétrique, Hôpital Cochin-Saint Vincent-de-Paul, Université Paris V, Paris, France.
authors.forename: Marie Helene
authors.initials: MH
authors.lastname: Poissonnier
authors.forename: Olivier
authors.initials: O
authors.lastname: Picone
authors.forename: Yves
authors.initials: Y
authors.lastname: Brossard
authors.forename: Jacques
authors.initials: J
authors.lastname: Lepercq
mesh_terms: D000328:Adult; D000367:Age Factors; D001805:Blood Transfusion, Intrauterine / Q000379:methods*; D004899:Erythroblastosis, Fetal / Q000628:therapy*; D017707:Erythrocyte Transfusion / Q000379:methods; D005078:Exchange Transfusion, Whole Blood / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007262:Infusions, Intravenous; D008297:Male; D011247:Pregnancy; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000401:mortality / Q000628:therapy*; D014471:Umbilical Veins