Department of Obstetrics and Prenatal Medicine, University Hospital Bonn, Bonn, Germany.
Praxis Für Pränatalmedizin Bonn, Bonn, Germany.
Arch Gynecol Obstet. 2023 Jul;308(1):117-125. doi: 10.1007/s00404-022-06712-z. Epub 2022 Aug 2.
Evaluating procedure-related complications and perinatal outcomes after intrauterine transfusion (IUT) before or after 20 weeks of gestation in fetuses with severe anemia due to intrauterine human parvovirus B19 infection.
A retrospective study investigating fetuses requiring IUT for fetal Parvo B19 infection in two tertiary referral centers between December 2002 and December 2021. Procedure-related complications, intrauterine fetal death (IUFD), and perinatal outcome were correlated to gestational age (GA) at first IUT, the presence of hydrops and fetal blood sampling results.
A total of 186 IUTs were performed in 103 fetuses. The median GA at first IUT was 19 (13-31) weeks of gestation. IUFD occurred in 16/103 fetuses (15.5%). Overall survival was 84.5% (87/103). Hydrops (p = 0.001), lower mean hemoglobin at first IUT (p = 0.001) and low platelets (p = 0.002) were strongly associated with IUFD. There was no difference observed in fetuses transfused before or after 20 weeks of gestation.
IUT is a successful treatment option in fetuses affected by severe anemia due to parvovirus B19 infection in specialized centers. In experienced hands, IUT before 20 weeks is not related to worse perinatal outcome.
评估因宫内人细小病毒 B19 感染而导致严重贫血的胎儿在 20 周之前或之后进行宫内输血（IUT）的与操作相关的并发症和围产儿结局。
对 2002 年 12 月至 2021 年 12 月期间在两家三级转诊中心因胎儿 Parvo B19 感染需要进行 IUT 的胎儿进行回顾性研究。将与操作相关的并发症、宫内胎儿死亡（IUFD）和围产儿结局与首次 IUT 时的胎龄（GA）、是否存在水肿以及胎儿血液采样结果相关联。
共对 103 例胎儿进行了 186 次 IUT。首次 IUT 的中位 GA 为 19（13-31）周。16/103 例胎儿发生 IUFD（15.5%）。总体存活率为 84.5%（87/103）。存在水肿（p=0.001）、首次 IUT 时平均血红蛋白水平较低（p=0.001）和血小板较低（p=0.002）与 IUFD 强烈相关。在 20 周之前或之后进行输血的胎儿之间没有观察到差异。
在专门中心，IUT 是治疗因细小病毒 B19 感染导致严重贫血胎儿的成功选择。在有经验的医生手中，20 周之前进行 IUT 与围产儿结局恶化无关。
