Transfusão intra-uterina para o tratamento de anemia fetal grave: experiência de 14 anos de um centro de diagnóstico pré-natal em Portugal

• Autor(a) principal: Rijo,Cláudia
• Data de Publicação: 2016
• Outros Autores: Cohen,Álvaro, Martins,Ana Teresa, Cruz,Jader, Queirós,Alexandra, Ramos,Helena, Correia,Joaquim
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S1646-58302016000200004
• topic: Intrauterine blood transfusion; Cordocenteses; Anemia

Overview and aims: Intrauterine blood transfusion (IBT) is an established technique for the treatment of severe fetal anemia, increasing the survival of these fetuses. We aimed to describe the experience of a single center in pregnancies complicated with severe fetal anemia, that underwent IBT. Study design, Population, Methods: A retrospective cohort study was conducted from January 1996 to June 2014. Data were collected from 98 IBT performed in 44 pregnancies. Data included: anemia etiology, gestacional age at IBT, hemoglobin and hematocrit levels, presence of hydrops, number of IBTs, gestacional age at birth, sex and weight. Neonatal data included: number of exchange transfusions, respiratory distress syndrome, sepsis and other complications. Results: The main cause of fetal anemia was anti-D alloimmunization in 79.5% of the cases and the mean gestational age (GA) of the first IBT was 26 weeks. The minimum pre-transfusion hemoglobin was 1.5 g/dL, with an average of 6.4g/dL. The post transfusion hematocrit increased to the desired values in 90% of cases. Nine fetuses (20.5%) had hydrops at diagnosis. We had 4 cases of fetal death, and 40 pregnancies resulted in live births, with mean gestational age of 34.3 weeks, average weight of 2446g and mean hemoglobin of 11g/dL. A cesarean was performed in most cases. The overall survival was 86.4%, since in addition to the four fetal deaths there were two cases of early neonatal death. Fetal hydrops and early GA seemed to be associated with a poorer prognosis. Conclusions: IBT is a safe and effective procedure for the treatment of severe fetal anemia. Vigilance should be done in hospitals with experience to allow timely and proper treatment of this condition.