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Changes in fetal acid base status during intravascular transfusion
U Nicolini1, J Santolaya, N M Fisk
1Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's Maternity Hospital, London.
Archives of Disease in Childhood
|July 1, 1988
Summary
Intravascular transfusions in fetuses with erythroblastosis fetalis can alter blood gas levels. Monitoring fetal blood gases is crucial, as some transfusions are linked to complications.
Area of Science:
- Perinatology
- Neonatology
- Fetal Medicine
Background:
- Erythroblastosis fetalis requires fetal blood transfusions.
- Umbilical venous blood gas analysis is used for monitoring.
Purpose of the Study:
- To assess changes in umbilical venous blood gas parameters after intravascular transfusions in fetuses with erythroblastosis fetalis.
- To correlate these changes with transfusion volume and outcomes.
Main Methods:
- Umbilical venous pH, PCO2, PO2, and base excess were measured before and after 72 intravascular transfusions in 34 fetuses.
- Data from 67 uncomplicated transfusions were analyzed to establish normal ranges for blood gas changes.
- Complications within six hours of transfusion were recorded.
Main Results:
- Uncomplicated transfusions caused a mean fall in pH and base excess, and a rise in PCO2.
- These blood gas changes correlated with increased fetal hemoglobin and packed cell volume.
- Five transfusions were associated with complications, including intrauterine death and fetal distress.
Conclusions:
- Intravascular transfusions induce predictable changes in fetal blood gases.
- Significant acute blood gas alterations can occur even in fetuses without pre-existing acidosis.
- Close monitoring is essential to detect potential complications following fetal transfusions.