Premium
The Place of Foetal Transfusion in Haemolytic Disease: A Report of 22 Transfusions in 16 Patients
Author(s) -
Green G. H.,
Liley A. W.,
Liggins G. C.
Publication year - 1965
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1965.tb00290.x
Subject(s) - medicine , contraindication , amniotic fluid , in utero , haemolytic disease , exchange transfusion , obstetrics , pregnancy , fetus , hydrops fetalis , fetal death , pediatrics , alternative medicine , pathology , biology , genetics
Summary:1 A series of 22 foetal transfusions performed in 16 patients over a period of 12 months is presented. 2 In infants hydropic at the first transfusion the procedure was of no benefit, all such infants dying in utero. Demonstrable hydrops is at present a contraindication to foetal transfusion. 3 Of 8 infants not hydropic at the first transfusion, 6 survived and were well at periods of 2 months of age and more. One developed hydrops prior to a second transfusion and one died in the neonatal period at 32 weeks after 3 foetal transfusions. 4 Amniotic fluid analysis is considered to be of the utmost importance in the selection of cases. 5 Some points in the technique are briefly discussed. No notable risks to foetuses so treated have yet been demonstrated. 6 The place of foetal transfusion in the management of pregnancy complicated by rhesus sensitization is discussed. Theoretically it should not be necessary in more than 1 in 2,000 pregnancies. Benefits accruing from the procedure are the saving of some babies poised between the risks of intrauterine death and neonatal death from prematurity, the drawing of attention to the prognostic value of amniotic fluid analysis by spectrophotometry, and an indication of the principle that it is possible to treat an infant in utero. 7 Any patient with rhesus sensitization whose amniotic fluid shows an optical density for the 450 mμ peak of above 0.20 between 28 and 32 weeks of pregnancy should be considered for foetal transfusion.