Hamzeh Catherine, Green Jessica, Hamadeh Grace, Korst Lisa M, Chmait Ramen H
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Childbirth Research Associates, North Hollywood, California, USA.
Fetal Diagn Ther. 2025;52(1):90-96. doi: 10.1159/000541560. Epub 2024 Sep 20.
To compare the blood volume transfused for fetal anemia in cases of placental chorioangioma versus red blood cell (RBC) alloimmunization in patients matched for gestational age (GA) and hydrops.
Study patients had intrauterine transfusions and were obtained from 3 sources: group (1) placental chorioangioma patients treated at our center (2016-2023); group (2) placental chorioangioma patients reported in the medical literature; and group (3) RBC alloimmunization patients treated for fetal anemia at our center (2016-2023) matched (2:1) to patients in groups 1 and 2 by GA at procedure and presence of hydrops. The expected volume (cc) of transfusion was calculated for all patients based on a formula commonly used for fetal anemia in cases of RBC alloimmunization that includes the GA at procedure, pre-transfusion hemoglobin, donor hemoglobin, and target hemoglobin. The ratio of the volume actually transfused to the expected volume was calculated for each group and for groups 1 and 2 combined; comparisons were made using nonparametric testing.
By group, the patients studied included: (1) 7 treated chorioangioma patients, (2) 8 chorioangioma patients described in the literature, and (3) 30 matched RBC alloimmunization patients. The median (range) GA at procedure for groups 1, 2, and 3 was 29.6 (22.7-32.7), 27.0 (24.0-30.0), 28.4 (22.7-34.3) weeks. The median pre-procedure hemoglobin for each group was 8.5 (5.8-12.5), 6.7 (5.6-12.0), and 5.3 (2.2-10.7) g/dL, and the median post-procedure hemoglobin for each group was 12.9 (11.5-14.0), 12.7 (9.6-14.7), and 13.6 (8.0-15.7) g/dL. The median (range) ratio of the actual to the expected volume transfused for each group was 2.50 (1.79-8.33), 1.64 (1.11-3.85), and 1.10 (0.69-1.86) (p < 0.001). When groups 1 and 2 were combined, the median ratio was 1.89 (1.11-8.33), which remained statistically significant when compared to group 3 (p < 0.001).
Intrauterine transfusion for fetal anemia in cases of large placental chorioangiomas appeared to require nearly twice the blood volume that was normally anticipated for cases of RBC alloimmunization, although the actual amount transfused varied widely.
To compare the blood volume transfused for fetal anemia in cases of placental chorioangioma versus red blood cell (RBC) alloimmunization in patients matched for gestational age (GA) and hydrops.
Study patients had intrauterine transfusions and were obtained from 3 sources: group (1) placental chorioangioma patients treated at our center (2016-2023); group (2) placental chorioangioma patients reported in the medical literature; and group (3) RBC alloimmunization patients treated for fetal anemia at our center (2016-2023) matched (2:1) to patients in groups 1 and 2 by GA at procedure and presence of hydrops. The expected volume (cc) of transfusion was calculated for all patients based on a formula commonly used for fetal anemia in cases of RBC alloimmunization that includes the GA at procedure, pre-transfusion hemoglobin, donor hemoglobin, and target hemoglobin. The ratio of the volume actually transfused to the expected volume was calculated for each group and for groups 1 and 2 combined; comparisons were made using nonparametric testing.
By group, the patients studied included: (1) 7 treated chorioangioma patients, (2) 8 chorioangioma patients described in the literature, and (3) 30 matched RBC alloimmunization patients. The median (range) GA at procedure for groups 1, 2, and 3 was 29.6 (22.7-32.7), 27.0 (24.0-30.0), 28.4 (22.7-34.3) weeks. The median pre-procedure hemoglobin for each group was 8.5 (5.8-12.5), 6.7 (5.6-12.0), and 5.3 (2.2-10.7) g/dL, and the median post-procedure hemoglobin for each group was 12.9 (11.5-14.0), 12.7 (9.6-14.7), and 13.6 (8.0-15.7) g/dL. The median (range) ratio of the actual to the expected volume transfused for each group was 2.50 (1.79-8.33), 1.64 (1.11-3.85), and 1.10 (0.69-1.86) (p < 0.001). When groups 1 and 2 were combined, the median ratio was 1.89 (1.11-8.33), which remained statistically significant when compared to group 3 (p < 0.001).
Intrauterine transfusion for fetal anemia in cases of large placental chorioangiomas appeared to require nearly twice the blood volume that was normally anticipated for cases of RBC alloimmunization, although the actual amount transfused varied widely.
比较胎盘绒毛膜血管瘤病例与红细胞（RBC）同种免疫病例中，针对胎龄（GA）和水肿情况匹配的胎儿贫血患者所输注的血量。
研究对象为接受宫内输血的患者，来自3个来源：组（1）2016 - 2023年在本中心接受治疗的胎盘绒毛膜血管瘤患者；组（2）医学文献中报道的胎盘绒毛膜血管瘤患者；组（3）2016 - 2023年在本中心接受胎儿贫血治疗的RBC同种免疫患者，按操作时的GA和水肿情况与组1和组2患者（2:1）匹配。根据RBC同种免疫病例中胎儿贫血常用的公式，为所有患者计算预期输血量（cc），该公式包括操作时的GA、输血前血红蛋白、供体血红蛋白和目标血红蛋白。计算每组以及组1和组2合并后的实际输血量与预期输血量的比值；采用非参数检验进行比较。
按组划分，研究的患者包括：（1）7例接受治疗的绒毛膜血管瘤患者，（2）文献中描述的8例绒毛膜血管瘤患者，以及（3）30例匹配的RBC同种免疫患者。组1、组2和组3操作时的GA中位数（范围）分别为29.6（22.7 - 32.7）、27.0（24.0 - 30.0）、28.4（22.7 - 34.3）周。每组输血前血红蛋白中位数分别为8.5（5.8 - 12.5）、6.7（5.6 - 12.0）和5.3（2.2 - 10.7）g/dL，每组输血后血红蛋白中位数分别为12.9（11.5 - 14.0）、12.7（9.6 - 14.7）和13.6（8.0 - 15.7）g/dL。每组实际输血量与预期输血量的中位数（范围）比值分别为2.50（1.79 - 8.33）、1.64（1.11 - 3.85）和1.10（0.69 - 1.86）（p < 0.001）。当组1和组2合并时，中位数比值为1.89（1.11 - 8.33），与组3相比仍具有统计学意义（p < 0.001）。
对于大型胎盘绒毛膜血管瘤病例中的胎儿贫血进行宫内输血，似乎需要的血量几乎是RBC同种免疫病例正常预期血量的两倍，尽管实际输血量差异很大。
比较胎盘绒毛膜血管瘤病例与红细胞（RBC）同种免疫病例中，针对胎龄（GA）和水肿情况匹配的胎儿贫血患者所输注的血量。
研究对象为接受宫内输血的患者，来自3个来源：组（1）2016 - 2023年在本中心接受治疗的胎盘绒毛膜血管瘤患者；组（2）医学文献中报道的胎盘绒毛膜血管瘤患者；组（3）2016 - 2023年在本中心接受胎儿贫血治疗的RBC同种免疫患者，按操作时的GA和水肿情况与组1和组
