title: [Intrauterine transfusión in alloimmunization Rh in México 1987-2008].
abstract: BACKGROUND
  Diagnosis, care and prevention of hemolytic disease in fetuses and newborns is the most prominent historical example of a successful medical procedure aimed to abate perinatal morbidity and mortality caused by a disease which for centuries was described only unknown origin.
  
  
  OBJECTIVE
  To review the perinatal outcome with intrauterine transfusion (IUT) in severe alloimmunization RhD over 21 years in a referral center of Mexico. The overall survival rate of fetuses and the relations with gestational age, and presence or absence of hydrops was analyzed. The authors present data about alloimmunization and a historical synopsis about IUT in México.
  
  
  METHODS
  A retrospective study was conducted from January 1, 1987, to January 31, 2008. It was collected only RhD immunizations. Primary outcome variables included gestational age and presence or absence of hydrops, type and number of IUT in each case, and we studied fetal and neonatal morbidity.
  
  
  RESULTS
  A total of 531 IUTs were performed in 150 fetuses. Severe hydrops was found at start of intrauterine treatment in 67 cases (45%). The survival rate was closely related to absence or presence of hydrops (88 and 60%), respectively. There were 123 liveborn fetuses and the procedure-related fetal loss rate was low (1.9%).
  
  
  CONCLUSIONS
  This study confirmed good outcome with IUT for fetal anemia and the loss rate was low and similar to another publications. The hydrops was the principal factor in the survival rate because late detection and referral of fetuses is critical for fetal and neonatal outcome.
authors.affiliation: Servicio de Medicina Materno Fetal, Hospital de Gineco-Obstetricia, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México. luijram@hotmail.com
authors.forename: Luis Javier
authors.initials: LJ
authors.lastname: Ramírez-Robles
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gómez-Partida
authors.forename: Guillermo
authors.initials: G
authors.lastname: Guevara-Rubio
authors.forename: Leonora
authors.initials: L
authors.lastname: Velázquez-Gómez
mesh_terms: D000037:Abruptio Placentae / Q000209:etiology / Q000401:mortality; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data; D001919:Bradycardia / Q000209:etiology / Q000401:mortality; D004899:Erythroblastosis, Fetal / Q000209:etiology / Q000628:therapy*; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D005315:Fetal Diseases / Q000209:etiology; D005865:Gestational Age; D006470:Hemorrhage / Q000196:embryology / Q000209:etiology / Q000401:mortality; D006771:Hospitals, Maternity / Q000706:statistics & numerical data; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology / Q000628:therapy*; D008800:Mexico / Q000453:epidemiology; D011247:Pregnancy; D011256:Pregnancy Outcome; D012017:Referral and Consultation; D012189:Retrospective Studies; D012203:Rh Isoimmunization / Q000150:complications*