title: Bilateral cystic encephalomalacia following multiple intrauterine transfusions for anti-Kell isoimmunisation.
abstract: Fetal and neonatal haemolytic diseases result from maternal allo-immunisation to fetal antigens. Maternal antibodies cross the placenta causing red cell haemolysis, resulting in fetal anaemia and, in severe cases, hydrops and perinatal death. Intravascular intrauterine blood transfusion (IUT) has markedly reduced perinatal mortality and is now a standard procedure. IUT is considered to be a safe procedure with fetal loss rate reported to be less than 5% and no reported increase in the rate of neurodevelopment impairment. In this report, we are presenting a case of bilateral cystic encephalomalacia following fetal anaemia secondary to anti-Kell iso-immunisation treated with multiple IUTs. Such a significant adverse outcome following IUT for anti-Kell iso-immunisation has not been reported in the literature. This case highlights the need for appropriate parental counselling and routine postnatal head ultrasound in all babies delivered following multiple IUTs.
authors.affiliation: Department of Paediatrics, Barts Health, London, UK.
authors.forename: Hesham
authors.initials: H
authors.lastname: Elsayed
authors.affiliation: Department of Paediatrics, Tunbridge Wells Hospital, Tunbridge Wells, UK.
authors.forename: Mansum
authors.initials: M
authors.lastname: Ng
authors.affiliation: Centre for the Developing Brain, King's College London, London, UK.
authors.forename: Mary
authors.initials: M
authors.lastname: Rutherford
authors.affiliation: Department of Paediatrics and Neonates, Tunbridge Wells Hospital, Tunbridge Wells, UK.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000740:Anemia / Q000196:embryology / Q000628:therapy; D001805:Blood Transfusion, Intrauterine / Q000009:adverse effects*; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000276:immunology; D037001:Directive Counseling; D004453:Echoencephalography; D004678:Encephalomalacia / Q000175:diagnosis* / Q000276:immunology* / Q000473:pathology; D005260:Female; D005315:Fetal Diseases / Q000276:immunology*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007626:Kell Blood-Group System / Q000276:immunology*; D008297:Male; D010290:Parents / Q000523:psychology; D011247:Pregnancy; D012203:Rh Isoimmunization / Q000150:complications* / Q000517:prevention & control
chemical_list: D007626:Kell Blood-Group System
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