Outcome of Early Severe Alloimmunised Pregnancies

To evaluate the perinatal outcome of early severely alloimmunised pregnancies.

This was a prospective observational comparative study of all Rh alloimmunised women who required IUT in less than 26 weeks of gestation. Outcome measures such as abortion, stillbirth, perinatal survival, and neonatal outcomes were compared with those who required IUT after 26 weeks gestation. Thinner needle (22G) and intrahepatic route preferentially were used for early transfusions.

Out of forty-four patients, 22 required transfusion at early gestation. A total of 152 IUT's were given in both groups. Mean number of IUT's was 4.5 ± 2 and 2.2 ± 1.4 in early and late group, respectively. There were two abortions in early group. One stillbirth occurred each in early & late groups while there were three neonatal deaths in late group. Hydropic foetuses were more likely to survive when they were treated early in gestation (80% vs. 66%). Take-home baby rate was 86.3% in early group which was higher than in late transfusion group (82.6%).

Proper technique and appropriate skill can reduce early IUT complications and improve survival. Results can be as good as those of foetuses who have late transfusions. Hydrops foetuses are more likely to survive if diagnosed and treated early.