Outcome of treatment

Article Abstract:

Fetal hemolytic disease is characterized by destruction of fetal red blood cells, which can result in severe anemia in the fetus. In some pregnancies, the mother's body produces antibodies that destroy fetal red blood cells and thereby cause this condition. Such fetuses usually require blood transfusions. Traditionally, these transfusions were given intraperitoneally (through the abdomen), although now simple intravascular transfusions, directly into the umbilical vein, are used in some hospitals. Cordocentesis is an easily performed technique for obtaining blood samples from the umbilical cord. These samples can be used to monitor red blood cell counts in the fetus. This study examined the effectiveness of treating fetal hemolytic disease by giving the fetus simple intravascular transfusions. Transfusions were given whenever it was deemed necessary on the basis of results of regular cordocentesis. A total of 142 transfusions were given to 48 fetuses based on monitoring with cordocentesis. Only two fetuses did not survive, for a survival rate of 96 percent. Of the fetuses that survived, 78 percent were delivered at term. None of the attempted transfusion procedures failed. Side effects of the transfusions were generally minor, with fetal bradycardia (slow heart rate) occurring in 8 percent of cases. In fetuses of at least 32 weeks' gestation, the interval between transfusions averaged four to five weeks. Outcomes were generally better for fetuses who received more than one transfusion. The results indicate that management of fetal hemolytic disease with simple intravascular transfusions and cordocentesis is highly effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Hemolytic anemia, Fetal diseases, Cordocentesis

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The association between fetal karyotype and mean corpuscular volume

Article Abstract:

Results of an earlier report showed a very high mean corpuscular (blood cell) volume in a fetus with a chromosomal abnormality (trisomy 21). This study was performed to see if there was a possible relationship between these two factors or between high mean corpuscular volume and fetal disease in general. Corpuscular volume was measured in four groups of fetuses, consisting of 50 control fetuses, 22 chromosomally abnormal fetuses, 31 growth-retarded fetuses, and 50 fetuses with hemolytic disease. When compared with the control group, corpuscular volume was significantly higher in the fetuses with chromosome abnormalities, but not in the other two groups. When the fetuses with chromosomal abnormalities were divided into two groups, one group having autosomal trisomy or triploidy (11 fetuses) and the other group having any other chromosomal disorders, corpuscular volumes were found to be significantly higher in the first subset of fetuses. No fetus with trisomy or triploidy had a normal corpuscular volume. Results suggest that when an elevated mean corpuscular volume in a fetus is discovered, chromosomal testing should be performed. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Risk factors, Genetic screening, Genetic testing, Chromosome abnormalities, Trisomy, Blood cells

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