title: Brain ultrasound findings in neonates treated with intrauterine transfusion for fetal anaemia.
abstract: BACKGROUND
  The main causes of severe fetal anaemia are red-cell allo-immunization, parvo B19 virus infection and feto-maternal haemorrhage. Treatment consists of intrauterine transfusion (IUT). Neuro-imaging studies in surviving neonates treated with IUT are scarce.
  
  
  OBJECTIVE
  To assess if neonates treated with IUT for fetal anaemia are at risk for cerebral injury, report the incidence and severity of brain ultrasound (US) abnormalities and explore the relation between brain US findings and perinatal parameters and neurological outcome.
  
  
  METHODS
  Brain US scans of neonates born alive between 2001 and 2008 with at least one IUT were retrospectively reviewed and classified as normal, mildly or moderately/severely abnormal. Incidences of abnormalities were calculated for full-term and preterm neonates. Presence and severity of abnormalities were related to clinical and IUT related parameters and to neurological outcome around 2 years of age (adverse: moderate or severe disability; favourable: normal or mild disability).
  
  
  RESULTS
  A total of 127 neonates (82 born preterm) were included. Median number of IUTs was 3 (range 1-6) and of brain US 2 (1-6). Median gestational age and weight at birth were 36.6 (26.0-41.1) weeks and 2870 (1040-3950)g. In 72/127 (57%) neonates ≥1 abnormality was seen on brain US, classified as moderate/severe in 30/127 (24%). Neurological outcome was adverse in 5 infants. Presence of brain US abnormalities was not significantly related to any of the perinatal parameters or to neurological outcome.
  
  
  CONCLUSIONS
  Neonates undergoing IUT for fetal anaemia are at high risk of brain injury.
authors.affiliation: Leiden University Medical Centre, Department of Paediatrics, Division of Neonatology , P.O. Box 9600, 2300 RC Leiden, The Netherlands. L.M.Leijser@lumc.nl
authors.forename: Lara M
authors.initials: LM
authors.lastname: Leijser
authors.forename: Nikki
authors.initials: N
authors.lastname: Vos
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Walther
authors.forename: Gerda
authors.initials: G
authors.lastname: van Wezel-Meijler
mesh_terms: D000740:Anemia / Q000628:therapy*; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects*; D001921:Brain / Q000196:embryology*; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000209:etiology; D002675:Child, Preschool; D004453:Echoencephalography; D005260:Female; D005315:Fetal Diseases / Q000628:therapy*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D011247:Pregnancy; D011250:Pregnancy Complications, Hematologic / Q000628:therapy