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[Complications of prevention and treatment of erythrocyte alloimmunization (case reports)]
Z Zizka1, P Calda, B Zlatohlávková
1II. gynekologicko-porodnická klinika, lékarské fakulty Univerzity Karlovy a Vseobecné fakultní nemocnice v Praze, Praha, Czech Republic.
Objectives:
The treatment of late recognized alloimunization with intraumbilical transfusions is more difficult and more often connected with complications.
Material And Method:
Between 1991-1997 we performed 70 intraumbilical transfusions in 25 fetuses for erythrocyte alloimunization. Six fetuses (24%) were hydropic in the beginning of the treatment. Eleven fetuses were delivered before 36 weeks of pregnancy. Two immature neonates (660 g and 1320 g) had intraventricular hemorrhage with neurologic complications. In six cases the transfusion was complicated by severe bradycardia of the fetus, but only twice the pregnancy was to be terminated by cesarean sectio during 24 hours after the procedure. Two of the 25 fetuses died antenataly and one postnataly, all of them primary hydropic. Two neonates had severe late onset anemia.
Conclusion:
Fetal alloimune anemia should be treated before onset of hydrops. The study was supported by the grant of IGA Ministry of Health CR No. 3200-3.