Pregnancy outcome for Rh-alloimmunized women.

OBJECTIVE

To compare perinatal results of Rh-alloimmunized pregnancies managed with spectrophotometric amniotic fluid analysis or fetal middle cerebral artery Doppler ultrasonographic velocimetry.

METHOD: A descriptive observational study involving 291 consecutive Rh-negative pregnancies. Group 1 consisted of 74 isoimmunized women managed with amniotic fluid spectrophotometry; group 2 of 25 isoimmunized women managed with Doppler ultrasonography; and group 3 of 192 nonimmunized Rh-negative women. The variables analyzed were need for intrauterine or neonatal transfusion, mode and time of delivery, birth weight, neonatal hematocrit, and perinatal mortality.

RESULTS

Need for intrauterine transfusion, birth weight, prematurity, rate of cesarean section, and perinatal mortality were similar in groups 1 and 2. Neonatal hematocrit was significantly lower and the need for neonatal transfusion was significantly higher when spectrophotometry rather than Doppler ultrasonographic velocimetry was used.

CONCLUSION

Fetuses managed with Doppler ultrasonographic velocimetry had a higher hematocrit at birth and a lesser need for neonatal transfusion, suggesting that this noninvasive method of monitoring fetal anemia is a better choice.