Neonatal outcome of fetuses receiving intrauterine transfusion for severe hydrops complicated by Rhesus hemolytic disease.

OBJECTIVE

To evaluate neonatal outcomes among a homogeneous group of fetuses with severe hydrops treated with intrauterine transfusion (IUT).

METHODS

In a prospective study at Dokuz Eylul University School of Medicine, Izmir, Turkey, outcomes were compared for 35 IUTs carried out between 2005 and 2010 in 19 pregnancies that were complicated by Rhesus D hemolytic disease with severely hydropic fetuses.

RESULTS

There was no correlation between the number of IUTs and the duration of phototherapy or number of exchange transfusions. After delivery, 36% (7/19) of neonates tested positive in a direct Coombs test and their requirement for exchange transfusion was higher than that of neonates who tested negative. The neonatal survival rate was 73.7%. Admission to the neonatal intensive care unit was 78%, and the median duration of neonatal unit stay was 4 days (range, 1-77 days). Only 1 newborn had hearing impairment.

CONCLUSION

IUT is a unique, gold standard treatment for severely hydropic fetuses. When treated optimally with IUT, fetuses with severe hydrops showed no increased risk of neurodevelopmental abnormalities. Factors affecting the survival of hydropic fetuses after IUT, and whether the number of IUTs performed affects the number of exchange transfusions required remain unclear.