title: [Analysis and perinatal outcome after intravascular transfusion].
abstract: BACKGROUND
  the leading cause of fetal anemia is Rh isoimmunization. The timely diagnosis by ultrasound and intravascular transfusion improves the prognosis.
  
  
  OBJECTIVE
  to evaluate the increase in hemoglobin in the fetus and correlate the red cell transfusion volume with elevation of hemoglobin and perinatal outcome.
  
  
  METHODS
  prospective, case series study. We included 17 patients with fetal anemia detected by measuring the peak systolic velocity of middle cerebral artery and determination of fetal hemoglobin before and after cordocentesis. After confirmation of fetal anemia (Hb <10 g/dL), was held fetal transfusion with 50 mL/kg estimated fetal weight, with packed red blood cells type O Rh negative.
  
  
  RESULTS
  In 17 cases fetal anemia was diagnosed, of which 11 (64%) had Rh isoimmunization and 6 (36%) were not immune. The 17 cases received 27 intravascular transfusions, in 75% hemoglobin rose to 10 g/dL, 45% in the first transfusion, 25% in the second and 10% in the third transfusion. Fetal hemoglobin between before and after transfusion was 6.5 and 12.9 g/dl, respectively (p<0.001) and allowed to continue the pregnancy from 3 to 12 weeks from the first transfusion. There were 4 deaths (2 stillbirths and 2 neonatal), but only one was related to the procedure. the survival rate was 76%, mortality in the presence of hydrops was 30% and no deaths in patients without hydrops.
  
  
  CONCLUSIONS
  Mortality in fetal anemia was 23.6% and only one case was related to intravascular transfusion. In cases of survival to birth, pregnancy lasted >30 weeks gestation. Hemoglobin rose from 27 to 300% of the initial fetal hemoglobin. The presence of fetal hydrops significantly increases mortality.
authors.affiliation: Departamento de Ginecología y Obstetricia, Unidad Médica de Alta Especialidad núm. 23, Instituto Mexicano del Seguro Social.
authors.forename: René
authors.initials: R
authors.lastname: Monico-Ramos
authors.forename: Mauro
authors.initials: M
authors.lastname: Ochoa-Flores
authors.forename: Ricardo Jorge
authors.initials: RJ
authors.lastname: Hernández-Herrera
authors.forename: Eduardo
authors.initials: E
authors.lastname: Flores-Pompa
mesh_terms: D000743:Anemia, Hemolytic / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D001783:Blood Flow Velocity; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D017218:Cordocentesis; D004899:Erythroblastosis, Fetal / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005312:Fetal Blood / Q000737:chemistry; D005313:Fetal Death / Q000453:epidemiology / Q000209:etiology; D005315:Fetal Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D015160:Hydrops Fetalis / Q000209:etiology / Q000401:mortality; D007231:Infant, Newborn; D020768:Middle Cerebral Artery; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D012203:Rh Isoimmunization; D050497:Stillbirth / Q000453:epidemiology
chemical_list: D006454:Hemoglobins