Hellmund Astrid, Geipel Annegret, Berg Christoph, Bald Rainer, Gembruch Ulrich
Department of Obstetrics and Prenatal Medicine, University Medical School Bonn, Bonn, Germany.
Fetal Diagn Ther. 2018;43(2):129-137. doi: 10.1159/000477208. Epub 2017 Jun 21.
To describe procedure-related complications and perinatal survival after intrauterine transfusion (IUT) before 20 weeks of gestation in fetuses with severe anemia due to human parvovirus B19 infection.
A retrospective study was conducted of all fetuses requiring IUT before 20 weeks of gestation in two tertiary referral centers between January 2002 and July 2015. Gestational age (GA) at first IUT, fetal blood sampling results, and presence of hydrops were related to procedure-related complications, fetal death (FD), and perinatal outcome.
A total of 93 IUTs was performed on 55 fetuses. The mean GA at first IUT was 16+6 (13+0-19+6) weeks. FD occurred in 11 (20.0%) of the 55 fetuses. Overall survival was 80.0% (44/55). Hydrops was present in 38.2% (21/55) and was strongly associated with FD (p = 0.001). There was no difference with regard to FD, hydrops, or hemoglobin concentration at first IUT in fetuses with transfusion before or after 16+0 weeks.
Severe anemia due to parvovirus B19 infection in the early second trimester can be treated successfully by IUT before 20 weeks of gestation in specialized centers with sufficient expertise.
描述因人类细小病毒B19感染导致严重贫血的胎儿在妊娠20周前进行宫内输血（IUT）后的手术相关并发症及围产期存活率。
对2002年1月至2015年7月期间两个三级转诊中心所有在妊娠20周前需要进行IUT的胎儿进行回顾性研究。首次IUT时的孕周（GA）、胎儿血液采样结果以及水肿情况与手术相关并发症、胎儿死亡（FD）和围产期结局相关。
共对55例胎儿进行了93次IUT。首次IUT时的平均GA为16 + 6（13 + 0 - 19 + 6）周。55例胎儿中有11例（20.0%）发生FD。总体存活率为80.0%（44/55）。38.2%（21/55）的胎儿存在水肿，且与FD密切相关（p = 0.001）。在16 + 0周之前或之后接受输血的胎儿，在首次IUT时的FD、水肿或血红蛋白浓度方面没有差异。
在具备足够专业知识的专业中心，妊娠中期早期因细小病毒B19感染导致的严重贫血可在妊娠20周前通过IUT成功治疗。
