Lemery D, Urbain M F, Van Lieferinghen P, Micorek J C, Jacquetin B
Service Gynecologie Obstétrique I, Maternité de l'Hotel Dieu, Université Clermont-Ferrand I, France.
Eur J Obstet Gynecol Reprod Biol. 1989 Nov;33(2):161-8. doi: 10.1016/0028-2243(89)90209-8.
Thirty intra-uterine exchange transfusions (I.U.E.T.) under ultrasound guidance were performed on 15 pregnancies in 14 severely Rh-sensitized women. Our technique and a new method of catheterization of the umbilical cord are described. I.U.E.T. were commenced at 19-34 gestational weeks and repeated up to 5 times at 15 to 60 days intervals. The lowest pretransfusion fetal hemoglobin was 3 milligrams at 25 weeks. All the hydrops (4 cases) reversed a few days after the first procedure. The survival rate is 50% for hydropic fetuses and 66.6% for all cases. This technique avoids fetal hypervolemia and also too repetitive procedures by quick renewal of red cells. Catheterization offers a simple and safe access to the umbilical vein even with important fetal movements.
对14名严重Rh致敏的孕妇的15次妊娠进行了30次超声引导下的宫内换血输血（I.U.E.T.）。描述了我们的技术以及一种新的脐带插管方法。I.U.E.T.在妊娠19 - 34周开始，每隔15至60天重复进行，最多5次。输血前最低胎儿血红蛋白在25周时为3毫克。所有水肿胎儿（4例）在首次操作后几天内症状逆转。水肿胎儿的存活率为50%，所有病例的存活率为66.6%。该技术通过快速更新红细胞避免了胎儿血容量过多以及过于重复的操作。即使胎儿有大幅度活动，插管也能提供简单安全的脐静脉通路。
