Keckstein G, Stoz F, Tschürtz S, Terinde R, Jonatha W D, Lauritzen C
Department of Obstetrics and Gynecology, University of Ulm, West-Germany.
J Perinat Med. 1989;17(5):341-9.
Twenty intrauterine, intravascular transfusion were performed in six patients under ultrasound guidance, the earliest one in the 19th week of gestation. In all twenty attempts we were able to insert the needle into the umbilical vein, transfuse between 12 and 80 ml of packed red blood cells, and raise the hematocrit (HK) up to 57% maximally. In two cases the fetal hydrops and the ascites completely disappeared. There was one complication in case 6. Fetal bradycardia developed after transfusion of 70 ml packed red cells in the 30th week. An immediate Caesarean sections was performed. The fetus was in a good condition and developed normally. All other fetuses were born by Caesarean section between 33 and 36 weeks of gestation and have had normal development up to now. These results show that the intrauterine, intravascular application of red blood cells is superior to the intraperitoneal approach. By the direct insertion into the cord the risk of fetal lacerations is minimal. On the other hand overtransfusion may occur more easily.
在超声引导下对6例患者进行了20次宫内血管内输血，最早一次在妊娠19周进行。在所有20次操作中，我们都能够将针头插入脐静脉，输注12至80毫升浓缩红细胞，并将血细胞比容（HK）最大提高到57%。2例胎儿水肿和腹水完全消失。病例6出现1例并发症。在第30周输注70毫升浓缩红细胞后出现胎儿心动过缓。立即进行剖宫产。胎儿状况良好，发育正常。所有其他胎儿均在妊娠33至36周时通过剖宫产出生，至今发育正常。这些结果表明，宫内血管内输注红细胞优于腹腔内输注方法。通过直接插入脐带，胎儿撕裂的风险最小。另一方面，更容易发生输血过量。
