Fetal anaemia as a cause of fetal injury: diagnosis and management.
OBJECTIVE
This review provides up-to-date information on the diagnosis and management of fetal anaemia.


RESULTS
Exciting advances in the field of red blood cell isoimmunization are phasing out the need for invasive procedures. Rhesus blood group genotyping using fetal DNA in maternal plasma has been introduced into clinical practice with remarkable success. The role of middle cerebral artery peak systolic velocity in screening for fetal anaemia has been confirmed in various causes of fetal anaemia. A recent review of a successful Iran national screening programme for thalassaemia provided a timely and valuable educational opportunity. The value of intrauterine transfusion as a treatment for fetal anaemia was demonstrated by both high success rate and low procedure-related pregnancy loss rate.


CONCLUSIONS
Fetal anaemia is one of the severe fetal conditions that affect the worldwide population. Rhesus isoimmunization remains an important health issue despite the recommendation for anti-D immunoglobulin prophylaxis and injection after sensitizing events. Noninvasive ultrasound diagnostic methods have replaced traditional invasive procedures in the assessment of fetus at risk of anaemia due to various causes, including red blood cell isoimmunization, parvovirus B19 infection and thalassaemia. The increased availability of intrauterine transfusion will help to improve the prognosis of these anaemic fetuses.
Chan
Lin Wai
LW
Department of Obstetrics and Gynaecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR. danielchan@cuhk.edu.hk
Lau
Tze Kin
TK
Chung
Tony Kwok Hung
TK
D001805:Blood Transfusion, Intrauterine; D004899:Erythroblastosis, Fetal / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D010322:Parvoviridae Infections / Q000097:blood / Q000150:complications; D016732:Parvovirus B19, Human / Q000472:pathogenicity; D011247:Pregnancy; D012204:Rh-Hr Blood-Group System / Q000276:immunology; D013789:Thalassemia / Q000175:diagnosis / Q000628:therapy; D016216:Ultrasonography, Prenatal
D012204:Rh-Hr Blood-Group System